Major Changes in the Diagnosis of Autism Debated at Conference

Posted on: 07 November 2013

The implications of the dropping of Asperger’s Disorder from the DSM-5 Diagnostic System will be addressed at an international conference in Trinity College Dublin organised by the School of Education and Aspire, the Asperger Syndrome Association of Ireland.

The two-day conference, entitled Challenging DSM-5, will focus on the controversial changes in the diagnosis of autism and the dropping of Asperger’s Disorder from the new DSM-5 (Diagnostic and Statistical Manual), produced by the American Psychiatric Association. Under the new new DSM-5 Asperger’s Disorder has been absorbed into the general diagnosis of autism spectrum disorders. This move is being viewed as problematic for many in the Irish health and education system.

Under the previous DSM (DSM-4) published in 1994, Asperger’s Disorder was recognised as a form of high-functioning autism with its own set of criteria such as the absence of any language delay in a child. Aspire estimates that about 15,000 people in Ireland are affected by Asperger’s Disorder.

The Challenging DSM-5 conference will highlight research carried out by Dr Carmel O’Sullivan, Head of the School of Education, Trinity, which has led to a much improved understanding of high functioning autism. Dr O’Sullivan will present and discuss the results of a major intervention into the development of social and communication skills for children and adolescents affected by high functioning autism through the use of a special type of drama called Social Drama.

Dr O’ Sullivan has identified 12 sub-types of Asperger’s Disorder through her ground breaking research with children over the past nine years. These sub-types allow for greater precision of diagnosis which will lead to a much better understanding of problems experienced by individuals with high-functioning autism, and to the development of therapeutic interventions and educational approaches targeted at the specific needs of each sub-type.

Dr O’ Sullivan commented: Although all of these children experience some problems socialising and communicating with others, they are all different and their strengths and areas of weakness present themselves in different ways which is reflected in their sub-type. For instance some are very chatty and ‘showman like’, others quite anxious and adult dependent, and some children can be quite passive and ‘coast’ along the edges without drawing too much attention to themselves. Those in each sub-type share very particular personality-type traits and physical characteristics which are easily identifiable, and quite unlike those in other sub-types. The identification of these 12 sub-types offers those with Asperger’s Syndrome, their parents, teachers and those in the medical professions with a finely tuned and differentiated way to communicate and interact in the world, as the approach to questions, conversation, eye contact, even things like seating arrangement preferences, will differ depending on which sub-type a person is most closely aligned with. Knowing how best to interact with a person according to his or her sub-type has led to a transformation of our Social Drama sessions and brings out the best in our children and young people as a result.”

Speaking about the dropping of Asperger’s Disorder from DSM-5 Diagnostic System, Michael Fitzgerald, Professor of Child and Adolescent Psychiatry at Trinity, said: “These recent changes to DSM are unfortunate and unhelpful. We need to lobby the World Health Organisation not to make the same mistake with ICD10 , the 10th revision of the International Statistical Classification of Diseases and Related Health Problems.”

Des McKernan, Honorary Secretary of Aspire, added:DSM-5 will have major implications for families awaiting diagnosis for their children and for people already diagnosed with Asperger’s Disorder. The immediate problem is that those who have already been diagnosed with Asperger’s Disorder do not know what their actual diagnosis is at the moment and they are also worried about losing the services they have – particularly with all the cut-backs going on at the moment. Some adults with Asperger’s have remarked that they feel a loss of identity – a bit like telling you that you can no longer call yourself Irish but must just call yourself a European.”

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