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

[Guest guest]

>

> *Update From: GRASP:

>

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

> theyÂ’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 studyÂ’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 &

> Gonzlez, 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*.

>

> *GRASPÂ’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/eeeyaraebmyataujmadaybm/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/eemsagaebmyadaujmataybm/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@...

>

> *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/eemuazaebmyanaujmakaybm/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