The American Psychiatric Association is looking to redefine autism, which may have a large effect on those currently suffering from the disorder.
The APA’s newly proposed definition for autism will categorize all degrees of the spectrum of the disorder under the same name. If approved, it will take effect in May 2013.
The different degrees — Autistic disorder, Asperger’s disorder, childhood disintegrative disorder and pervasive developmental disorder — will all be known as autism spectrum disorder. In addition, diagnostic criteria are also being redefined for the disorders as a whole.
However, these new developments have sparked controversy among physicians and patients.
“The real worry is that the new criteria will be narrower and that people with a certain subtype of autism may not fit into the spectrum,” Director of the Center of Autism Research Robert Schultz said.
He said if this happens, it may be difficult for current Asperger’s patients to get services. For students under the age of 21, schools are required to offer certain services such as extra time on tests and note-takers. Though Schultz doubts patients will lose these accommodations, mental health benefits such as insurance may change, as they are often tied to a diagnosis.
Educational therapist Renee Weiss, on the other hand, thinks the new changes will have a large effect on students.
“We’ll lose all funding for all students who are not listed as being on the autistic spectrum,” she said. Additionally, certain educational aides — such as note-takers and extra testing time — may not be provided for these students, she said.
Schultz said the new criteria will have a range of severity and will still include Asperger’s disorder as part of the autism spectrum. The APA is also narrowing the new diagnostic criteria, merging several social and communication criteria and eliminating one of the affected domains. They believe the changes are a better reflection of what they know about the spectrum’s pathology.
“[Asperger’s disorder] looks like someone who’s a little quirky, who may be somewhat awkward socially and who has very restricted interests,” said Children’s Hospital of Philadelphia pediatrician Jennifer Pinto-Martin. “It’s the high functioning end of the spectrum.”
She added that a psychiatrist or a developmental pediatrician diagnoses people on the spectrum. They test patients with the Autism Diagnostic Observation Schedule, a face-to-face exam in which they rank patients on criteria such as communication and social interaction skills.
But once patients are diagnosed, there is no set treatment for any of the disorders on the spectrum.
This is one of the main reasons many physicians are supporting the definition change. With the new diagnostic criteria, physicians can more easily uncover the cause of autism and effective treatments, Schultz said.
“There’s a strong rationale for wanting to do this,” he added.
However, Asperger patients and their families have voiced another concern over the changes. Asperger’s patients prefer to be set apart, Schultz said. They don’t want to be grouped with the broader spectrum.
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