Disney Information Station Logo

Go Back   The DIS Discussion Forums - DISboards.com > Disney Trip Planning Forums > disABILITIES! > disABILITIES Community Board
Find Hotel Specials & DIScounts
 
facebooktwitterpinterestgoogle plusyoutubeDIS UpdatesDIS email updates
Register Chat FAQ Tickers Search Today's Posts Mark Forums Read





Reply
 
Thread Tools Rate Thread Display Modes
Old 01-27-2011, 07:36 PM   #1
GraceLuvsWDW
DIS Veteran
 
GraceLuvsWDW's Avatar
 
Join Date: Mar 2007
Location: Texas-halfway between The Land and The World
Posts: 2,347

The DSM-5 Austim Diagnostic Criteria-what do you think?

What do you think of the proposed changes?
http://www.dsm5.org/ProposedRevision...n.aspx?rid=94#


I like that they added the sensory issues. Do you think the severity levels are adequate? I could see how changes in environment might make a difference in the severity.
__________________
DLR Aug 1977 * WDW Villas at Disney Institute Oct 1999 * WDW CSR/OKW Sept 2007
WDW Pop Jan 2008 * WDW Pop May 2008 * WDW Pop/WH Sept 2008 * WDW WH Dec 2008
WDW Pop Mar 2009 * WDW WH June 2009 * DLR Aug 2009 * WDW Poly Sept 2009 * DLR Dec 2009
WDW Pop Mar 2010 * WDW POFQ June 2010 * DLR Aug 2010
WDW WL & WBC June 2011 * DLR Dec 2011
WDW WBC June 2012
DCL Magic March 2013 * Currently Planning: WDW Beach Club/Swan August 2013
GraceLuvsWDW is offline   Reply With Quote
Old 01-27-2011, 09:04 PM   #2
jodifla

DIS Veteran
 
Join Date: Jan 2002
Location: South Florida & Motown
Posts: 10,773

I think this will put a whole lot more children on the autism "spectrum."

I think that the word "deficits" not being defined is a very, very bad idea.

It seems to me the more they try to define it with each subsequent DSM-V, the worse they make it for children.
jodifla is offline   Reply With Quote
|
The DIS
Register to remove

Join Date: 1997
Location: Orlando, FL
Posts: 1,000,000
Old 01-28-2011, 12:13 AM   #3
disfan07
DIS Veteran
 
disfan07's Avatar
 
Join Date: Mar 2006
Posts: 3,459

It depends. We are learning about this right now in developmental psychopathology.

I dont believe that each subsequent DSM has made it worse for children. In fact, comparing the previous DSMs, the current DSM (DSM-IV-TR) has actually been very good for children and adolescent diagnoses.

I dont believe that diagnosing children and adolescents via the DSM will ever be as accurate and reliable as diagnosing adults. That is one of the big issues with the DSM. We keep getting more reliable and accurate with diagnosing adults and we are trying to play catch-up with diagnosing children.

One of the bigger problems is the medical model used for creating and diagnosing psychological disorders. While it is a great base for it, it is not the end all and some professional still use it as the only way to diagnose children.

Luckily, that seems like it is changing because we are learning less and less about the medical model and more about the multiaxial system and using not as mnay concrete methods. The problem is, to be covered by insurance companies and to be used by professionals, they have to be empirically based so there are limits as to what can be done. There has to be some concrete evidence to test for reliabiity and validity of the methods.

Obviously, this is not an opinion coming from someone who has a child that has been diagnosed. This is just from what I have expereinced by going for my psychology degree and what we have been learning so far.
__________________
All Star Sports (2007, 2008); All Star Music (2001); Caribbean Beach (1992, 1994, 1996, 1997, 1999); Coronado Springs (2004); Port Orleans French Quarter (2007); Port Orleans Riverside (2014); Wilderness Lodge (2006); Pop Century (2010, 2012); Saratoga Springs (2013); The Contemporary (2013); Grand Floridian (2014)
disfan07 is offline   Reply With Quote
Old 01-28-2011, 05:36 AM   #4
bookwormde
Heading out now, another adventure
Have a good time, WDW is a magical place
 
bookwormde's Avatar
 
Join Date: Mar 2008
Posts: 5,571

At first look it is a great improvement over 4 or the even first draft of 5 although it still completely misses the EF component, although since there is a separate criteria for ADD/ADHD, it is addressed at a level as long as a child can be classified as both (so that inappropriate methodologies to treatment are not used).

I do not think this will qualify additional children for those who have been seen by a highly qualified clinical group, but will help clinicians with less competency have a better chance of an appropriate diagnosis (although with the higher functioning kids they sill will need to have gained training and experience under in a highly qualified clinical group).

I especially like the explanatory rational sections which speaks very directly to the faults with DSM-4 and the severity charting which will end the "it does not look like classis Autism" issue (for this clinicians who take the time to read it).

(apologies to disfan07 since it sound like you are in one of the better program, unlike that vast majority of your predecessors)
As with most of these issues I have to "live with it" for a while to really pick it apart.
Considering it is created by Psychiatrists who are disease/affliction (instead of understanding it from the evolutionary genetic variation modal which the scientific community has adopted) and treat the manifestations (instead of the underlying EF and social skill and sensory differentials), based in their training and are probably the least qualified to understand the boarder impact of ASD it is amazingly good.

As with most of these issues I have to "live with it" for a while to really pick it apart

Jodifla
I agree that "deficits" is a very imprecise and inappropriate term for understanding our kids, since differentials which "limit and impair everyday functioning" would be much more appropriate, but in reality it is "insurance language"

bookwormde
__________________

Last edited by bookwormde; 01-28-2011 at 05:49 AM.
bookwormde is offline   Reply With Quote
Old 01-28-2011, 06:12 AM   #5
disfan07
DIS Veteran
 
disfan07's Avatar
 
Join Date: Mar 2006
Posts: 3,459

Quote:
As with most of these issues I have to "live with it" for a while to really pick it apart.
I agree. I dont think you can really pick apart something like this until it is seen at work. Until it has been implemented for a while, I dont think anyone truly knows how or what impact it will have on children and adolescents.

Taking Abnormal Psychology and Developmental Psychopathology really opens up your eyes to what is good and what is not so good in teh field of Psyhcology. When it comes to a diagnosis, I believe the medical model approach is one of the major issues. At least they don't consider children to be mini adults anymore like they did originally in the DSM.
__________________
All Star Sports (2007, 2008); All Star Music (2001); Caribbean Beach (1992, 1994, 1996, 1997, 1999); Coronado Springs (2004); Port Orleans French Quarter (2007); Port Orleans Riverside (2014); Wilderness Lodge (2006); Pop Century (2010, 2012); Saratoga Springs (2013); The Contemporary (2013); Grand Floridian (2014)
disfan07 is offline   Reply With Quote
Old 01-28-2011, 08:58 AM   #6
jodifla

DIS Veteran
 
Join Date: Jan 2002
Location: South Florida & Motown
Posts: 10,773

The caregiver exclusion is also very worrisome. If you have a connected, socially reciprocal relationship with a caregiver, Dr. Stanley Greenspan considered that s pretty definite sign it was NOT autism.

Children with severe language delays/disorders can't keep up long conversations....it is in the nature of the disorder. And when they meet strangers, they are naturally wary and shy. They don't make eye contact (they don't want the failure of not being able to converse -- and when you look at someone, that's the first thing they expect...conversation). They often can't hear well in crowds so don't try to join in big groups.

But have just a couple people around, and they are able to keep up with the conversation better. They relax, warm up, show their true colors quickly.
jodifla is offline   Reply With Quote
Old 01-28-2011, 09:12 AM   #7
jodifla

DIS Veteran
 
Join Date: Jan 2002
Location: South Florida & Motown
Posts: 10,773

Quote:
Originally Posted by disfan07 View Post
It depends. We are learning about this right now in developmental psychopathology.

I dont believe that each subsequent DSM has made it worse for children. In fact, comparing the previous DSMs, the current DSM (DSM-IV-TR) has actually been very good for children and adolescent diagnoses.

I dont believe that diagnosing children and adolescents via the DSM will ever be as accurate and reliable as diagnosing adults. That is one of the big issues with the DSM. We keep getting more reliable and accurate with diagnosing adults and we are trying to play catch-up with diagnosing children.

One of the bigger problems is the medical model used for creating and diagnosing psychological disorders. While it is a great base for it, it is not the end all and some professional still use it as the only way to diagnose children.

Luckily, that seems like it is changing because we are learning less and less about the medical model and more about the multiaxial system and using not as mnay concrete methods. The problem is, to be covered by insurance companies and to be used by professionals, they have to be empirically based so there are limits as to what can be done. There has to be some concrete evidence to test for reliabiity and validity of the methods.

Obviously, this is not an opinion coming from someone who has a child that has been diagnosed. This is just from what I have expereinced by going for my psychology degree and what we have been learning so far.
As the parent of a misdiagnosed child (well, the school TRIED to misdiagnose him, but we wouldn't let them) I view things quite differently.

I'm on message boards with hundreds (and our last message board literally had thousands -- we moved to upgrade) of parents of late talking children, most of whom have been misdiagnosed with autism or PDD-NOS. It's a nightmare for these parents, because the treatments that tend to work in autism DON'T work with children whose problems all stem from their lack of receptive language. Most of these children also have some other quirks...but what they don't lack is the innate social ability. But if you try to assess them in an hour, you'll likely see an anxious child who shuts down, because they KNOW you are testing them. They KNOW they are failing, so they'd rather not do anything at all. The schools then bully and threaten the parents and tell them that if they don't accept their autism dx, their child will get no help at all. I've heard this literally countless times.

Schools are often handing out the wrong "educational" diagnosis, but some major autism centers hand out wrong Dxes as well.

The word "deficits" (and the word deficits would indicate to me ANYTHING off the norm) is what makes this DSM such a bad idea to me. It WILL be abused unless they put in enough qualifying material to delineate what the word "deficit" means.


As our late talkers grow up, it becomes obvious that they aren't autistic. But parents tell us they regret the time they anguished over their child, running from therapy to therapy, losing their precious childhood.
jodifla is offline   Reply With Quote
Old 01-28-2011, 10:19 AM   #8
chskover
Mouseketeer
 
chskover's Avatar
 
Join Date: May 2008
Location: Ohio
Posts: 261

My daughter was diagnosed with ADHD at the age of 5. This was after taking her to many doctors. This was also followed with "we think she is slightly autistic, but can't diagnosis her with that." She was 16 yrs old when a Psychologist told me she had Asperger. After much research, it was like our eyes were finally opened. That was a major turning point for us in understanding her condition. She is now 24 and a mother of twin girls and doing great. To bad I wasn't told sooner or we might have been given more help.
__________________
Me , DD (27) DD (26) DGD (4)DGD (4)



2014 BWV
2013 AllStar Sports, 2012 POR Riverside;2012 POP/CBR; 2011 AKL/BLT; 2010 AKL/OKW; 2009 SSR; 2009 POP; 2008 SSR; 2007 FW Cabins; 2001 Allstar Music; 1999 CBR; 1996 Offsite
1979 Yogi Bear Campground
chskover is offline   Reply With Quote
Old 01-28-2011, 12:20 PM   #9
disfan07
DIS Veteran
 
disfan07's Avatar
 
Join Date: Mar 2006
Posts: 3,459

Quote:
The word "deficits" (and the word deficits would indicate to me ANYTHING off the norm) is what makes this DSM such a bad idea to me. It WILL be abused unless they put in enough qualifying material to delineate what the word "deficit" means.
I understand your concerns but I still dont think anyone can say that it WILL be abused or for certain how it will actually impact anyone until it is used. I believe that is really jumping the gun.

The DSM is really not cut and dry. It is not completrely straightfoward. There are a lot of things in it that can only be completely understood by a professional. So while I dont doubt that you probably know a lot about it, there are also probably somethings that you dont know about it as well.
__________________
All Star Sports (2007, 2008); All Star Music (2001); Caribbean Beach (1992, 1994, 1996, 1997, 1999); Coronado Springs (2004); Port Orleans French Quarter (2007); Port Orleans Riverside (2014); Wilderness Lodge (2006); Pop Century (2010, 2012); Saratoga Springs (2013); The Contemporary (2013); Grand Floridian (2014)
disfan07 is offline   Reply With Quote
Old 01-28-2011, 01:34 PM   #10
clanmcculloch
DIS Veteran
 
clanmcculloch's Avatar
 
Join Date: Feb 2009
Location: New Hampshire
Posts: 5,570

Quote:
Originally Posted by disfan07 View Post
I understand your concerns but I still dont think anyone can say that it WILL be abused or for certain how it will actually impact anyone until it is used. I believe that is really jumping the gun.

The DSM is really not cut and dry. It is not completrely straightfoward. There are a lot of things in it that can only be completely understood by a professional. So while I dont doubt that you probably know a lot about it, there are also probably somethings that you dont know about it as well.
You know, that was rather condescending. Some of us have taught many a professional a thing or two (or 20 or 50) about autism. As a future professional, I really hope you learn to actually listen to your patients (or patients' advocates) rather than assuming that they can't comprehend the nuances of autism (that's what you said when you state that a lot of things can only be completely understood by a professional).

Many of us have first hand experience with professionals who didn't understand the old criteria so we're pretty skeptical that these same professionals will take the time to understand the new criteria. Far too many professionals (psychiatrists, neurologists, psychologists, etc) who claim to diagnose and treat kids on the spectrum come up with their own interpretations for vague concepts like these.

Based on the new criteria, I can definitely see many professionals saying that my 13yo is NOT on the spetrum because her social-emotional reciprocity deficit is not as described in that link. She does have an abnormal social approach but she can carry a very mature back and forth conversation about many topics and is extremely interested in learning about all sorts of topics even they're not her own interests and is very VERY expressive and initiates social interactions quite frequently. Obviously I'm just picking apart A1 but that's the one that IMO could be a huge sticking point for her. She does definitely have deficits (her IEP has several goes to work on furthering her deficits every year so clearly they're visible to her special ed team and not just me) but if a professional just looks at what's written here rather than actually understanding the full spectrum of social-emotional deficits and expectations then she would not be diagnosed as being on the spectrum. I'm sure that there are professionals who will "get" it just like the psychologist, SLP and OT who helped to diagnose her but they did so based on the old criteria which didn't spell it out correctly either. I've also experienced psychiatrists and neurologists and psychologists who pulled out the DSM-IV and looked at it like an all inclusive checklist and said she's not on the spectrum because she doesn't look like the exact narrow picture described by the narrow example in the DMS-IV. The professionals who DO focus their careers in autism treatment all agree that DD13 definitely has Asperger Syndrome.

Look, I know your intentions are good. I agree that there's no way to know if this will be better, worse or no different for kids on the spectrum until we see how it gets implemented. I'm just very skeptical that the human beings who are using this are going to look at it any differently than they look at the DSM-IV. Any professional who's diagnosing autism should have an understanding of autism that does NOT rely solely on the DSM-V any more than they should have relied solely on the DSM-IV. I'm really glad to read your description of the training that you're experiencing. It does give me some hope that future professionals will be better equipped to understand autism than many of the ones that many of us have encountered.
__________________
Me DH DD(16) DD(14) DSD(32) DSSil (41) DGD (newborn) DSD(30) DGS(4)




Multi-Allergy & Autism Dining Reviews: February 2014 * DL & LA July 2013 * February 2013 * August 2012 * February 2012 * August 2011 * August 2010


February 2014 AKL: me, DH, DD15, DD13 * July 2013 DL offsite (Tropicana): me, DH, DD15, DD12, DSD30, DSSil * February 2013 WDW Poly: me, DH, DD14, DD12
August 2012 WDW FW Cabin & AoA Nemo: me, DH, DD14, DD12, DD12's BFF11 * February 2012 WDW Poly CL: me, DH, DD14, DD11 * August 2011 WDW YC: me, DH, DD13, DD11
February 2011 WDW Poly CL: me, DH, DD13, DD10, DSD28, DSSil * August 2010 WDW POFQ & Poly CL: me, DH, DD12, DD10 * June 2010 WDW Pop: me, DH, DD12, DD9
December 2009 WDW POFQ: me, DH, DD11, DD9 * February 2009 WDW Pop: me, DH, DD11, DD8 * August 2008 WDW SSR: me, DH, DSD25, DSD24, DD10, DD8
September 2007 WDW Pop: me, DH, DD9, DD7 * April 2002 DLR offsite: me, DH, DSD19, DSD17, DD4, DD1.5 * June 2000 DLR offsite: me(pregnant), DH, DSD17, DSD15, DD2
January 1994 WDW offsite: me, DH, DSD11, DSD9 * January 1992 WDW offsite: me, DH, DSD9, DSD7
clanmcculloch is offline   Reply With Quote
Old 01-28-2011, 04:28 PM   #11
bookwormde
Heading out now, another adventure
Have a good time, WDW is a magical place
 
bookwormde's Avatar
 
Join Date: Mar 2008
Posts: 5,571

There are 2 types of social skills and competency, familiar (family/caregiver) and societal, for our children who are cognitively intact a very high percentage have reasonably good familiar skills, their innate societal skills, not so much.

I am familiar with Dr. Greenspan and now his son's work and they make a clear distinction between classically autistic individual and higher functioning and I have had a chance to ask about this very issue at one of the seminars.

This is exactly why they excluded the familiar situation (caregivers) since otherwise you would miss the vast majority of higher functioning kids.

bookwormde
__________________

Last edited by bookwormde; 01-28-2011 at 05:10 PM.
bookwormde is offline   Reply With Quote
Reply



Thread Tools
Display Modes Rate This Thread
Rate This Thread:

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump

facebooktwitterpinterestgoogle plusyoutubeDIS Updates
GET OUR DIS UPDATES DELIVERED BY EMAIL



All times are GMT -5. The time now is 11:22 PM.

Powered by vBulletin® Version 3.8.4
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.

Copyright © 1997-2014, Werner Technologies, LLC. All Rights Reserved.