Re: DSM-5 Proposed Revision - Social Communication Disorder

[Guest guest]

My " overall " on this newly coined disorder. The medical profession is famous for

getting things wrong, and when it can't admit ignorance, it just makes up new

labels. Problem with this particular one is that medical doctors are among the

least qualified to tease out the subtleties required to judge whether one has

social communication challenges. First, it isn't in their essential medical

training...not in US medical schools. Second, their profession has openly

acknowledged, repeatedly and in length, its practitioners' own problems

communicating appropriately, let alone effectively, with lay persons, and, in

particular, their own patients. Third, medical doctors long ago " gave away "

authority to be experts on speech and communication, and there are at least two

well-established, doctoral level professions far more experienced and advanced

in their understanding of social communication: speech language pathology and

speech pragmatics, and second, clinical psychology. Both separate disciplines

were created largely in reaction and direct response to the deficiencies of

medicine to act appropriately when it came time not only to diagnose, but also

treat communication challenges of ALL kinds, not just speech. For example,

movement disorders have rapidly come under the sway of occupational therapists,

and there has arise a well-respected branch of that practice, tied in closely

with behavioral psychology, to identify movement AS communication, and AS social

communication, specifically. To entrust the medical profession to this area is

sheer tom-foolery.

For these reasons alone, the Social Communication Disorder label should not be

found in the DSM. For one thing, the Brits are at least fifteen years ahead of

the American Psychological Association in identifying and successfully treating

speech pragmatics challenges because, for one thing, their culture is more

homogenous than ours, and thus it's easier to adopt common definitions without

the challenge of dealing with vast cultural differences in the use and

understanding of what appear to be on the surface, " the same words. " Secondly,

the Brits have developed THE ONLY diagnostic instrument that's met medical and

scientific validation as a diagnostic instrument, not just a predictive tool of

an eventual medical diagnosis of ASD, and that instrument is the Diagnostic

Interview for Social Communication Disorders, or the DISCO, for short. That

instrument was developed carefully and over a very long period of time with an

MD, Dr. Lorna Wing, and her non-medical but extremely savvy colleagues at

Elliott House, now renamed the Wing Centre, as a direct consequence of the

Autistic Society's expenditure of much time and professional expertise in

developing an effective diagnostic tool for ASD. While no single diagnostic

instrument can or should be used solely by itself as a determinant for medical

labeling, the DISCO (so-named by Dr. Gillberg and his wife)IS an

effective diagnostic tool for ASD which the American Psychiatric Association,

almost to " a man, " has steadfastly ignored and poo-pooed to such an extent that

the DISCO is NOT recommended for administration in the US, nor are promising

young psychologists or medical doctors encouraged to consider going to the UK to

learn how to administer the instrument.

So...for no other reason than looking at the psychiatric community's arrogance

and sheer idiocy, it should be apparent that the medical profession in this

country is the least qualified to add " anything social " to its arsenal of

weapons until its practitioners demonstrate not only an empathetic understanding

of ASD, as proposed, but also demonstrate real expertise in training and use of

effective social communication on its own, without regard to the profession's

built-in assumption that once it has the power to label, it has the unbridled

and unquestionable yet untrained power to understand, let alone communicate,

common-sense.

Other mental health and developmental health professions didn't just arise

willy-nilly. They've done so because of the purblindness and arrogance of the

medical profession and its members' refusal to get down and admit that they're

stumped when indeed they are, and that others, not just themselves, are capable

of understanding the human condition.

Just my not so humble opinion.

N. Meyer

DSM-5 Proposed Revision - Social Communication

Disorder

>

>

>

>Those who struggle with pragmatics impairments in the social uses of

>verbal and nonverbal communication may already have difficulty receiving

>a DSM sanctioned diagnosis that will allow them greater access to services.

>

>And with the proposed revisions that fold Aspergers into Autistic

>Spectrum Disorder and purport to tighten up the diagnostic criteria,

>much alarm has been expressed that more people are likely to fall

>through the cracks.

>

>This proposed revision to the DSM-5 may be helpful to NLD and Aspergers

>folks alike though. Take a look at the diagnostic criteria that is

>being proposed. Sound familiar?

>

>

>http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=489

>

>

>Best,

>~CJ

>

>

>

>

>

>------------------------------------

>

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[Guest guest]

What axis does this fall under? If it is NOT considered a developmental disorder, good luck getting any help at all.  This will get tossed to the speech pathologist, social worker recreational therapist. I'm betting if your kid skates by with average school work (even if it is a struggle), you MIGHT be offered a 504 plan.

This is a garbage can diagnosis, which give schools a ton of wiggling out room. There is an Aspie at my friend's elementary school who will not make the cut with the new DSM V. They have told the parents the para pro will be gone next year -as he is meeting the academic expectations-which is all the school cares about.  The para pro is there to keep the chaos down because this poor boy has no clue about social interactions.  At lunch time he runs around, dances etc. , but since he is scoring above average in class work with minimal help, no need for assistance (eye roll).  He has no true friends. The kids don't bully him, and try to include him in soccer games etc, but he just has no clue on the give and take part.

D. probably meets this criteria, but as the AI teacher told my.friend, the school is only worried about him learning. No one cares if " he can't socialize well with others " , unless it becomes a safety issue ie aggressive behavior or the regular teacher can't handle his outbursts.

Nanci

 

Those who struggle with pragmatics impairments in the social uses of

verbal and nonverbal communication may already have difficulty receiving

a DSM sanctioned diagnosis that will allow them greater access to services.

And with the proposed revisions that fold Aspergers into Autistic

Spectrum Disorder and purport to tighten up the diagnostic criteria,

much alarm has been expressed that more people are likely to fall

through the cracks.

This proposed revision to the DSM-5 may be helpful to NLD and Aspergers

folks alike though. Take a look at the diagnostic criteria that is

being proposed. Sound familiar?

http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=489

Best,

~CJ

[Guest guest]

NJ Delphia wrote:

>

>

> What axis does this fall under? If it is NOT considered a

> developmental disorder, good luck getting any help at all.

>

No equivalent condition exists in the DSM-4, so I'm not sure about the axis.

The " Rationale " tab contains more detail though. In reading the text,

the comment, " interactions that were socially inappropriate but did not

meet the criteria for autism " suggests to me that the disorder is

considered developmental, meeting only the social communication and

language pragmatics subset of the autism diagnostic criteria.

Does that make sense?

Best,

~CJ