Fw: [Autism] [AS] Fwd: Very Important DSM-5 Update

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----- Forwarded Message -----To: cobbm@...; Amber Steet ; Tad Doezema ; Thor Armbruster ; alvarezv@...; perweinv@...; guimbardae@...; hayess@...; maffetb@...; saraiehernandez@...; monadyjune@...; rodgersj@...; birdm@...; kelleys@...; elliotd@...; calacil@...; calacig@...; Meika Lee ; Lacy ; Kayleigh Joiner ; Lacie ; Lexis ; joseph.villareal1993@...; poleim@...; dailyj@...;

kaheecomputerguru@...; lyndamalcolm@...; gamer9106@...; cookj@...; lampertr@...; bradshawv@...; martzr@...; toyre@...; floresri@...; brownsa@...; smithb@...; rickettsl@...; Osterhaus ; mattsons@...; nicholss@...; Roper ; janice.moran@...; kay.heinecke@...; elizabeth.soto@...; christopher.wright@...; jonesr@...; clarkc@...; Judy Hay ; Toby Also-Trabulsi ; Dale Carmody ; Cristi Fleming Sent: Sunday, January 29, 2012 9:12:13 PMSubject: [Autism] [AS] Fwd: Very Important DSM-5 UpdateHi, all. Check this email out.---- Original Message ------From: Ellen Jannol <elkepelka1@...Subject: [AS] Fwd: Very Important DSM-5 UpdateDate sent: Sat, 28 Jan 2012 18:46:36 -0800*Update From: GRASP:Please forward to anyone and everyone you deem appropriate, especially ifthey’ve been following the DSM-5 debate closely . . . ***Dear all:A second study that has just come to light claims that the DSM-5 willsignificantly reduce the amount of people (by 32.3%) who will qualify foran autism spectrum diagnosis. Furthermore, this study indicates that thosewhose diagnoses are eliminated by the newer criteria will include the morechallenged, and not just the end of the spectrum that is

better able tomirror greater society.Given the statements of many DSM-5 Committee members since the story brokelast Thursday, this study corroborates many fears, but it also raises newquestions (our summations will follow the study’s excerpts).GRASP is grateful to authors, Dr. A Worley and Dr. ny L. Matsonof Louisiana State University, along with their representatives, for givingGRASP permission to post quotes from "*Comparing Symptoms of AutismSpectrum Disorders using the Current DSM-IV-TR Diagnostic Criteria and theProposed DSM-5 Diagnostic Criteria*" (in press for "*Research in AutismSpectrum Disorders*").*Excerpts* (2) from the final "*Discussion*" section of the study are asfollows:1. “The proposed revisions to the diagnostic category of ASD aresignificant . . . It was hypothesized that children meeting only

DSM-IV-TRdiagnostic criteria (APA, 2000) for ASD would score significantly higher(i.e., indicating more symptom severity) than children who were typicallydeveloping and significantly lower than those who met future diagnosticcriteria 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 significantlyhigher than the typically developing children, but not significantlydifferent than children meeting DSM-5 diagnostic criteria (APA, 2011).Thus, children and adolescents that no longer met criteria still hadsignificant symptoms of ASD when compared to children who were typicallydeveloping. Even more concerning is that children and adolescents who metcurrent, but not future diagnostic criteria had similar symptom severity ofASD when compared to

children and adolescents who continued to meetdiagnostic criteria. Therefore, the subset of children who met DSM-IV-TR,but not DSM-5 diagnostic criteria are experiencing significant impairmentsrelated to the core symptom domains of ASD. Thus, the proposed revisionsmay be decreasing sensitivity, suggesting that that the broader symptomdefinition 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 deliveryafter early intervention services subside is urgent given the changingdiagnostic categories and criteria of ASD proposed for the DSM-5 (APA,2011). However, if ongoing treatment is necessary, who will pay for theseservices? Interventions currently utilized to treat individuals diagnosedwith various ASDs are largely consistent and similar

treatmentmethodologies should remain despite the newly proposed diagnosticcategory. However, payment coverage for these children will likely becomean obstacle. About a decade ago, the majority of insurance companies hadexclusions for autism (Peele, Lave, Kelleher, 2002), but most now coverservices for those diagnosed. However, it is probable that insurancecompanies will not provide treatment coverage for children who stillexhibit significant symptoms of ASD, but no longer meet diagnostic criteriaunder the DSM-V definition of the disorder. Another implication of the proposed diagnostic changes will beapparent in incidence and prevalence rates of ASD. With the proposal tonarrow the symptom definition, fewer children will meet diagnostic criteriaupon the publication of the DSM-5 (APA, 2011). Thus, a decreasing trend ofincidence and

prevalence rates should be observed once the DSM-5 isutilized diagnostically. A decrease in prevalence rates for ASD wasobserved in the current study when utilizing the DSM-5 diagnostic criteriacompared to the DSM-IV-TR (APA, 2000). In the current study, the prevalenceof 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 maycome at the cost of providing services to those who still require them. In closing, the proposed revisions to the diagnostic categoryof 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'sauthors) is as follows:This study backs up some of the numbers that Yale's Dr. Fred Volkmar citedin his study as reported in the New YorkTimes<http://t.ymlp282.net/eeeyaraebmyataujmadaybm/click.php> whenthis story broke last Thursday. Dr. Volkmar, who earlier resigned from theDSM-5 Committee, has had his study attacked by proponents of the newercriteria since then who seek to invalidate his findings. Two studiesremotely corroborating each other (as we believe these two do) will be hardto attack.GRASP has cited the disparity, and sometimes contradictory nature ofdamage control attempts by several DSM-5 Committee members in several mediaarticles. But now that the evidence is quite strong that changes will be asdrastic as feared, if not more so, it paints many in a negative

light whohave tried to downplay the level of change forthcoming, but it especiallypaints Dr. H. Hunter in a poor manner. In what was a suspiciousarticle to begin with (no contrary opinion provided—shame on author,Deborah Brauser), Dr. King's comments in last week's MedScapearticle<http://t.ymlp282.net/eemsagaebmyadaujmataybm/click.php> shouldnow be looked upon in the light of, at best, misrepresentation. Wethinksthose who reassuringly tell us "No one will be left behind" really mean "Noone 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 ormedia professionals. You can request a copy by emailing press@...*What can you do* if reducing the criteria threatens your child's specialeducation funding, your services as an adult, or your self-esteem as anadult? Please maintain the following outline without letup:1. Sign the petition foundhere<http://t.ymlp282.net/eemuazaebmyanaujmakaybm/click.php>,and forward the link with your appeal for people to sign everywhere andanywhere. Again: forwarding (especially through any and all appropriatesocial media sites) is arguably more important than signing