Doctors want to redefine autism; parents worried
In this April 4, 2012, photo, Kelly Andrus holds her son Bradley in his classroom at Children's Choice Learning Centers Inc., in Lewisville, Texas. Bradley, who turns three in a couple of weeks, was diagnosed a year ago with mild autism. For the first time in nearly two decades, experts want to rewrite the definition of autism. Some parents fear that if it's narrowed and their kids lose the label, they may also lose out on special therapist. (AP Photo/Tony Gutierrez)
(AP) -- One child doesn't talk, rocks rhythmically back and forth and stares at clothes spinning in the dryer. Another has no trouble talking but is obsessed with trains, methodically naming every station in his state.
Autistic kids like these hate change, but a big one is looming.
For the first time in nearly two decades, experts want to rewrite the definition of autism. Some parents fear that if the definition is narrowed, their children may lose out on special therapies.
For years, different autism-related labels have been used, the best known being Asperger's disorder. The doctors working on the new definition want to eliminate separate terms like that one and lump them all into an "autism spectrum disorder" category.
Some specialists contend the proposal will exclude as many as 40 percent of kids now considered autistic. Parents of mildly affected children worry their kids will be left out and lose access to academic and behavioral services - and any chance of a normal life.
But doctors on the American Psychiatric Association panel that has proposed the changes say none of that would happen.
They maintain the revision is needed to dump confusing labels and clarify that autism can involve a range of symptoms from mild to severe. They say it will be easier to diagnose kids and ensure that those with true autism receive the same diagnosis.
With new government data last week suggesting more kids than ever in the U.S. - 1 in 88 - have autism, the new definition may help clarify whether the rising numbers reflect a true increase in autism or overdiagnosis by doctors.
There is no definitive test for autism. The diagnosis that has been used for at least 18 years covers children who once were called mentally retarded, as well as some who might have merely been considered quirky or odd. Today, some children diagnosed with autism may no longer fit the definition when they mature.
"We're wanting to use this opportunity to get this diagnosis right," said Dr. Bryan King, a member of the revision panel and director of the autism center at Seattle Children's Hospital.
The revision is among dozens of changes proposed for an update of the psychiatric association's reference manual, widely used for diagnosing mental illnesses. The more than 10,000 comments the group has received for the update mostly involve the autism proposal, with concerns voiced by doctors, researchers, families and advocacy groups. A spokeswoman declined to say whether most support or oppose the autism revision.
The group's board of trustees is expected to vote on the proposals in December, and the updated manual is to be published next year.
Among the proposed changes:
- A new "autism spectrum disorder" category would be created, describing symptoms that generally appear before age 3. It would encompass children with "autistic disorder," now used for severe cases, plus those with two high-functioning variations.
A diagnosis would require three types of communication problems, including limited or no conversation and poor social skills; and at least two repetitive behaviors or unusual, limited interests, including arm-flapping, tiptoe-walking and obsession with quirky topics.
- Autistic disorder and high-functioning variations - Asperger's disorder and PDD-NOS, or "pervasive developmental disorder not otherwise specified" - would be eliminated, but their symptoms would be covered under the new category.
Asperger's kids often have vast knowledge about a quirky subject but poor social skills; PDD-NOS is notoriously ill-defined and sometimes given to kids considered mildly autistic.
- Another new category, "social communication disorder," would include children who relate poorly to others and have trouble reading facial expressions and body language. A small percentage of children now labeled with PDD-NOS would fit more accurately into this diagnosis, autism panel members say.
They say the changes make scientific sense and are based on recent research.
Opponents include older kids and adults with Asperger's who embrace their quirkiness and don't want to be lumped in with more severe autism, and parents like Kelly Andrus of Lewisville, Texas. Her son, Bradley, was diagnosed with mild autism a year ago, at age 2.
"I'm really afraid we'd be pushed out of the services we get," she said. That includes a free preschool program for autistic kids and speech and occupational therapy, which cost her $50 a week. The family has no medical insurance.
Opponents also include a well-known Yale University autism researcher, Dr. Fred Volkmar, who was on the revision panel but says he was unhappy with the process and quit. "I want to be sure we're not going to leave some kids out in the cold," he said.
Volkmar is senior author of a study suggesting that the revision would exclude nearly 40 percent of children with true autism. But members of the revision panel have challenged Volkmar's methods, saying he relied on outdated data from two decades ago.
One major advocacy group in the field, Autism Speaks, said it is awaiting further research on the effects of the revisions before deciding whether to endorse them.
Dr. James Harris, a panel member and founding director of the developmental neuropsychiatry program at Johns Hopkins University, said the proposal will provide a better label for children who really only have communication problems.
"I don't want a child labeled as autistic, which suggests a chronic, lifelong problem, when he has a social communication problem that may get better if he has proper services and his brain matures," Harris said.
Harris said these kids don't need intensive autism therapy but should be eligible for other types of special education typically offered in public schools.
Dr. Daniel Coury, chief of developmental and behavioral pediatrics at Nationwide Children's Hospital in Columbus, Ohio, said parents have valid concerns because insurance companies and schools may not immediately recognize that children receiving the new diagnosis may need special services.
"So there may potentially be a lag time where services would not be available," he said.
He noted it is already difficult for many families to get costly autism therapy. Some insurers don't cover it, and many financially strapped school districts have cut special education.
More information: Diagnostic manual: http://www.dsm5-org
©2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
- Proposed autism diagnostic criteria roils medical community Feb 05, 2012 | not rated yet | 0
- Two-Thirds of kids with autism have been bullied: study Mar 30, 2012 | not rated yet | 0
- Autism expert on proposed changes to autism diagnosis Jan 23, 2012 | not rated yet | 0
- DSM-5 proposed criteria for autism spectrum disorder diagnosis Jan 23, 2012 | not rated yet | 0
- More autism reported, likely from better testing Mar 29, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Absorption of light by spherical nanoparticle
3 hours ago Hello Can anyone tell me how the absorption of a polystyrene nanoparticles scales as a function of its diameter. The particle is spherical and...
Solvability of a circuit
7 hours ago Let's say I have a circuit consisting only of a finite number of batteries and resistors, all ideal. Given an arbitrary shape of this circuit, will I...
Question about perception of colors around light sources
11 hours ago When I look at a distant light source (like car headlights, or street lamp lights) I notice colors of the visible spectrum (as separated (as in after...
Does a charged particle rotate when traveling through a static Bf?
12 hours ago I have been looking at mass spectrometers, in particular the interactions between the Bf ind of a charged particle in motion in a static Bf of the...
Find a link between physics and assignment problems
13 hours ago Hi ! I've been working about assignments problems and how to solve them. I will have to do a presentation about it in few weeks. However, I'll...
Light as a source of electricity
14 hours ago Hello Dear Fellows! We all know that light is an electromagnetic wave and also we know that an antenna receives EM waves and...
- More from Physics Forums - Classical Physics
More news stories
Research by Victoria University PhD education graduand Larah van der Meer highlights the importance of understanding the communication preferences of children with developmental disabilities such as autism.
Autism spectrum disorders May 14, 2013 | 3.3 / 5 (3) | 1
At times, Andy Shih still finds himself overwhelmed by the groundswell of interest in autism applications he's seen in the three years since Apple Inc. released the first iPad.
Autism spectrum disorders May 09, 2013 | 2 / 5 (1) | 0
Children with autism see simple movement twice as quickly as other children their age, and this hypersensitivity to motion may provide clues to a fundamental cause of the developmental disorder, according ...
Autism spectrum disorders May 08, 2013 | not rated yet | 0 |
(AP)—Autism scientists are seeking more brain samples for research.
Autism spectrum disorders May 02, 2013 | 5 / 5 (1) | 0
A novel study reports that white men and women of European descent inherit common foot disorders, such as bunions (hallux valgus) and lesser toe deformities, including hammer or claw toe. Findings from the Framingham Foot ...
48 minutes ago | not rated yet | 0 |
Whole-cell pertussis vaccines were more effective at protecting against pertussis than acellular pertussis vaccines during a large recent outbreak, according to a new Kaiser Permanente study published in Pediatrics.
35 minutes ago | not rated yet | 0 |
Optimal treatment of sleep apnea in patients with prediabetes improves blood sugar (glucose) levels and thus can reduce cardiometabolic risk, according to a study to be presented at the ATS 2013 International Conference in ...
21 minutes ago | not rated yet | 0 |
Touted for safety, ease and patient convenience, peripherally inserted central catheters have become many clinicians' go-to for IV delivery of antibiotics, nutrition, chemotherapy, and other medications.
56 minutes ago | not rated yet | 0
Researchers at Mayo Clinic have developed a promising method to distinguish between pancreatic cancer and chronic pancreatitis—two disorders that are difficult to tell apart. A molecular marker obtained from pancreatic ...
41 minutes ago | not rated yet | 0
A new measure of the heterogeneity – the variety of genetic mutations – of cells within a tumor appears to predict treatment outcomes of patients with the most common type of head and neck cancer. In the May 20 issue ...
21 minutes ago | not rated yet | 0