APA's new diagnostic manual: Asperger's Disorder to be Dropped

[Anita18]

The problem I see with it is that, if you want to say that mental illness is a disease just like cancer, then you can't take every human behavior that presents on a continuum and draw an arbitrary line in the sand and say anyone whose behavior crosses that line has a disease. Being anti-social is not a disease. I think operating like this completely weakens the argument that mental illness is a disease. This is bad for people who have mental illnesses that actually are diseases because it makes it hard for them to be taken seriously and to get treatment.

It's also bad for the ones who don't have diseases because now some of them get labeled and thrown into a system when there is absolutely nothing wrong with them.

IMO diagnosis of disease need to be saved for people whose bodies don't work right. We know some people's brains (which are an organ in the body) are broken. Those are the people who need a diagnosis. Not kids who aren't well behaved, adults who get easily distracted, etc. They need coping strategies for getting along in a society they are at odds with but that's not the same thing as treating a disease.

Of course, we do have to remember that these are the same people and the same book that claimed being gay was a mental illness at one time. I don't really take a lot of stock in what they say. Which is easy enough for me -- I'm a software engineer. I feel sorry for people whose ability to do their job is impacted by this book.

Exactly. Alf and I are introverted, but in different ways. I've seen discussions about considering introverts as having very mild autism, but I don't think I agree with that. Crowds don't bother me. Loud noises don't bother me. (In fact, the more bass, the better!) I just prefer being by myself. Both crowds and loud noises bother Alf though, a lot, so I suppose his brand of introversion can be considered slightly autistic.

But it doesn't affect his everyday life. I suppose if he wanted to be a CEO of a large company, it would, but many people make career decisions based on what they can handle socially. I think that's where the line should be drawn - if something is affecting your everyday life in an extremely negative way. Being easily distracted is not a disorder, unless it's so bad you can't hold down any job. And "frequent temper tantrums" of a normal amplitude (ie, no human or property damage) are an inconvenience, not a disorder.

[Angelskates]

Exactly. Alf and I are introverted, but in different ways. I've seen discussions about considering introverts as having very mild autism, but I don't think I agree with that. Crowds don't bother me. Loud noises don't bother me. (In fact, the more bass, the better!) I just prefer being by myself. Both crowds and loud noises bother Alf though, a lot, so I suppose his brand of introversion can be considered slightly autistic.

God, no. I'm an introvert, crowds do bother me. I have sensory issues, but I am not autistic. Plenty of people have some autistic traits/tendencies, but it doesn't make them "slightly autistic". This is the thinking that has society in trouble, IMO, everything needs a label. You're either on the autistic scale, or you're not. There's not such thing as slightly autistic, any more than there's "a little bit dyslexic" or "a bit ADHD". You're your own normal, and everyone is different.

[AragornElessar]

I'm not a fan of many of the other changes being proposed/made, but I am a fan of this one. I think many of the changes will lead to more medicated children. A new diagnosis for severe frequent temper tantrums, disruptive mood dysregulation disorder - I fear kids won't be able to be "naughty" anymore without getting a label Sometimes kids are just being kids, and sometimes the underlying issue isn't a psych diagnosis, but parent discipline, teacher training, others issues with the child, or assistance needed in other ways. Labels are very hard to reverse.

This almost happened w/a cousin of mine. He kept getting his work done long before the rest of the Class, so since he was bored, he was "causing trouble". A meeting took place between his Parents (His Mom's my First Cousin), the Teacher and the Principal and guess what happened? They wanted him put on meds because he "had ADHD".

To say his Dad told them off from what I've heard is an understatement. Not only that, but his Mom/my First Cousin is a Pharamcist. They told the two of them this w/out any medical assessment at all and the only "proof" of Andrew's ADHD being a problem and or disruption of the Class. My Cousins then also told the Teacher and Principal unless they had an assessment done, and that assessment done by a Mental Health Professional of their choosing, not the School Board's, that proved Andrew needed the meds was the only way he was going on those meds. They also told the Teacher to give Andrew more work, since it was happening every day and she had to know by then what would end up happening.

She couldn't do that. That would mess up her lesson plans.

Not only did Andrew end up at a different school, but he was also tested. Twice. Once for ADHD, which he wasn't. The other testing was to see what his Learning Levels were. He ended up being in the Gifted program until Graduation.

However, if they hadn't stood up to the Teacher and Principal, Andrew would have been another one of those kids we all hear of who got branded ADHD just because he was causing trouble and w/out the assessment.

From what I understand of what I've read about this change, as Angelskates said, I'm scared we're about to see a slew of kids simply labeled ADHD and medicated due to whatever *other than* ADHD, Autism or the other childhood mental issues we've heard of the last few years.

Just to me, this sounds like a very slippery slope things are headed down.

[Anita18]

God, no. I'm an introvert, crowds do bother me. I have sensory issues, but I am not autistic. Plenty of people have some autistic traits/tendencies, but it doesn't make them "slightly autistic". This is the thinking that has society in trouble, IMO, everything needs a label. You're either on the autistic scale, or you're not. There's not such thing as slightly autistic, any more than there's "a little bit dyslexic" or "a bit ADHD". You're your own normal, and everyone is different.

I'm not calling my fiance autistic either, but there is a definite difference between where our introversion originates. Labeling IMO doesn't really mean anything unless you actually do something with that information. I'm more thinking out loud than anything else. Human personalities can be pretty fascinating.

And isn't autism already on a scale? You have those who can talk and those who can't. Do they need different diagnoses?

I actually believe we're all on every spectrum there is, on some level, but there's no need to find a specific treatment or medicate for it unless it IS affecting your life very negatively. We are our own normal, as you said. But I believe that just because we're on a spectrum, doesn't mean that we need to be "treated" for anything. Then again I have a very self-deprecating nature.

[Angelskates]

I'm not calling my fiance autistic either, but there is a definite difference between where our introversion originates. Labeling IMO doesn't really mean anything unless you actually do something with that information.

With kids, just having the label can in sometimes be detrimental. The same for some parents. Sometimes the parents want a diagnosis to explain their child's behaviour, when it's really just the child's own tendencies and part of their personality. With labels comes stigma. With some labels, comes answers, but sometimes I think they're a cop-out, an excuse not to try and get to know the child and work with his or her uniqueness. I think this especially when the diagnosis automatically leads some to medication.

And isn't autism already on a scale? You have those who can talk and those who can't. Do they need different diagnoses?

They get a a scaled autistic diagnosis - the autistic scale is mild (sometimes called high functioning), moderate and severe. High functioning/mild autism and Aspergers overlap so much that there is very little difference, except with what insurance companies and schools cover. Aspergers was always the "better" diagnosis; the one parents beg for over autism.

[michiruwater]

There is nothing wrong with being an introvert. We live in a society that prefers extraversion, so people who are introverts are seen as the lesser species, but it's just a different personality type. Depending upon what you read, between 25-50% of the US is introverted. I really doubt that 1/4 to 1/2 of the country has 'mild autism'. Honestly, as an introvert I'm kind of offended by that remark. I'm also both perplexed and offended by the idea that an introvert who is bothered by crowds is showing signs of autism. Um, what? What if they're just claustrophobic? Ridiculous.

[Anita18]

With kids, just having the label can in sometimes be detrimental. The same for some parents. Sometimes the parents want a diagnosis to explain their child's behaviour, when it's really just the child's own tendencies and part of their personality. With labels comes stigma. With some labels, comes answers, but sometimes I think they're a cop-out, an excuse not to try and get to know the child and work with his or her uniqueness. I think this especially when the diagnosis automatically leads some to medication.

I find this pretty prevalent in adults who try to self-diagnose themselves too. For example, I'm a member of an INFJ group on Facebook (I readily admit I'm not 100% INFJ, but I do share many qualities), and it seems like many members there try to explain their personalities and quirks through the lens of being an INFJ. "I'm an INFJ, so that's why I do this. It explains everything about my personality!"

I find that compartmentalizing your entire personality through one label is going overboard, but many people will continue to do so, whether through official avenues or not. I know it's difficult to de-stigmatize such labels, but that will have to be necessary. It's not bad, it's just different. That's all.

Having a label on something may even help to accept that part of yourself. When I was in HS and college, I didn't feel normal because I was so introverted. I didn't like to party or hang out a lot, and I put pressure on myself because of that. Realizing that introverts really do need different things from extroverts help me accept that there was nothing wrong with me. I'm an introvert. I'm different. And that's okay.

Having that kind of awareness and ease with myself and my own introversion definitely helped my relationship with my fiance too, because he's even more introverted than I am. Many people simply don't know what to do with him. I just let him be and he definitely appreciates that. But first you have to accept that he's a very sensitive introvert and that he has certain needs.

I definitely have more patience with my cousin than his own brother and my sister do. I've accepted that he very likely as Asperger's and that he can't help his personality quirks, so I might as well just roll with it. There's definitely two sides to having labeling someone in that manner, so YMMV. It really depends on the people involved.

[Anita18]

There is nothing wrong with being an introvert. We live in a society that prefers extraversion, so people who are introverts are seen as the lesser species, but it's just a different personality type. Depending upon what you read, between 25-50% of the US is introverted. I really doubt that 1/4 to 1/2 of the country has 'mild autism'. Honestly, as an introvert I'm kind of offended by that remark. I'm also both perplexed and offended by the idea that an introvert who is bothered by crowds is showing signs of autism. Um, what? What if they're just claustrophobic? Ridiculous.

Never said there was anything wrong with being introverted. I'm introverted and proud to say I did not step foot outside my apartment today. I had a great time by myself.

We just need to de-stigmatize mental illness, above all. Just what is so wrong about being mildly autistic? I have no problem with it if I'm part of that group. You or I or Angelskates obviously don't need treatment. It just might help explain why we are the way we are. It's just for curiosity's sake and something to consider.

[VIETgrlTerifa]

I'm learning about how the courts are skeptical regarding defenses that are mental in nature such as the insanity plea in criminal cases or mental handicaps that are not considered defenses in tort law and therefore the defendants aren't afforded the the same defenses compared to someone who may have caused a serious automobile accident injuring one's property due to a sudden physical ailment.

Not saying if there's a right answer or wrong answer, but the skepticism seems to stem from people's mistrust of psychology as a science. I think this thread is illustrating that as well.

[Angelskates]

Never said there was anything wrong with being introverted. I'm introverted and proud to say I did not step foot outside my apartment today. I had a great time by myself.

We just need to de-stigmatize mental illness, above all. Just what is so wrong about being mildly autistic? I have no problem with it if I'm part of that group. You or I or Angelskates obviously don't need treatment. It just might help explain why we are the way we are. It's just for curiosity's sake and something to consider.

I don't need treatment because I don't have autism. A child with mild autism needs support in some way in order to learn certain things, cope in society, and integrate, find a job that suits, hold a job etc. Maybe not long term, but if they have autism, they will need some form of support at some time, to learn strategies that may (or may not) be able to be implemented independently. Having mild autism is not the same as being introverted and having some "personality quirks". I know several people with Aspergers who are extroverts, or at least, that's how they see themselves. I know lots of social kids with autism.

Why can't you have patience for your cousin even if he doesn't "very likely" have Aspergers? Can't you just "roll with" his personality quirks without labelling him? Why do you need to consider him "very likely as Asperger's" before you have patience and roll with his personality quirks? What if that's just him, and not something that can be labelled? Could you have patience then?

I think it's better to understand yourself, your personality, your traits and tendencies as a human being, rather than as a label. I also think it's better to try and understand others this way.

I work with kids with special needs, and their families, and try saying it this way: First, he/she's a person, second he's a your son (or brother, etc), and then he has x, y, and z, which means he has autism. The autism is not who he is, he's a person, he's your son, and he happens to have autism. The autism label never goes away, but the person, the son, the x, y, and z is what we work with. The x, y and z are more important to me than the label of autism. I don't need the label - if there's x, y and z; I can work with your child on that. "Autism" as a label means nothing without the actual person, and for each person the x, y and z is different - sometimes common factors, but never exactly the same. Children (and adults) with autism are as unique as those without. Too often the label is put before the child, and thrown around as an answer when it really isn't. That x, y, and z isn't helped by giving a label, and shouldn't need a label in order to be worked on. Labels can be really useful, especially in my work, as a starting point and getting diagnosis reports (if there is one) is one part of our intake, it's good for background and saves us asking the same questions, but based on all of this, I couldn't even tell you where I would start with a child, until I met him/her, and even then, only after several sessions to I really start to decide what I want to focus on. Because I try not to focus on the label, and instead focus on the child. Anita18, I think you really want to think you do this, but you needed to give your cousin a label in order to accept his quirkiness, and to me, that's a shame.

I'm an INTJ, and I don't care, I don't think it's good or bad. I'm me. I just found out it means I am not suited to teaching though but actually my job is awesome, and I think I am good at it.

[Anita18]

I don't need treatment because I don't have autism. A child with mild autism needs support in some way in order to learn certain things, cope in society, and integrate, find a job that suits, hold a job etc. Maybe not long term, but if they have autism, they will need some form of support at some time, to learn strategies that may (or may not) be able to be implemented independently. Having mild autism is not the same as being introverted and having some "personality quirks". I know several people with Aspergers who are extroverts, or at least, that's how they see themselves. I know lots of social kids with autism.

Why can't you have patience for your cousin even if he doesn't "very likely" have Aspergers? Can't you just "roll with" his personality quirks without labelling him? Why do you need to consider him "very likely as Asperger's" before you have patience and roll with his personality quirks? What if that's just him, and not something that can be labelled? Could you have patience then?

I think it's better to understand yourself, your personality, your traits and tendencies as a human being, rather than as a label. I also think it's better to try and understand others this way.

I work with kids with special needs, and their families, and try saying it this way: First, he/she's a person, second he's a your son (or brother, etc), and then he has x, y, and z, which means he has autism. The autism is not who he is, he's a person, he's your son, and he happens to have autism. The autism label never goes away, but the person, the son, the x, y, and z is what we work with. The x, y and z are more important to me than the label of autism. I don't need the label - if there's x, y and z; I can work with your child on that. "Autism" as a label means nothing without the actual person, and for each person the x, y and z is different - sometimes common factors, but never exactly the same. Children (and adults) with autism are as unique as those without. Too often the label is put before the child, and thrown around as an answer when it really isn't. That x, y, and z isn't helped by giving a label, and shouldn't need a label in order to be worked on. Labels can be really useful, especially in my work, as a starting point and getting diagnosis reports (if there is one) is one part of our intake, it's good for background and saves us asking the same questions, but based on all of this, I couldn't even tell you where I would start with a child, until I met him/her, and even then, only after several sessions to I really start to decide what I want to focus on. Because I try not to focus on the label, and instead focus on the child. Anita18, I think you really want to think you do this, but you needed to give your cousin a label in order to accept his quirkiness, and to me, that's a shame.

I think we are agreeing on the big ideas, but simply choose to call them different things.

I "label" my cousin so I know what he needs. So I can get an idea of where he's coming from. I don't work with special needs kids, I have no background on that. As you said, it's a starting point. He doesn't need special treatment, because he has parents who don't want to change who he is - they've simply accommodated for his abilities, and he has quite an extensive number of abilities. But I definitely have other family members who actively avoid him because he's "weird." I believe that's a shame. And as long as we learn to accept him, by whatever means possible, isn't that the most important part?

I had to label myself as an introvert to fully accept that part of my personality. It's like, "Okay, it has a name, it's a thing, I can go somewhere with this." I think that's just the way I approach it. But I certainly don't explain my entire personality through being an introvert, just as I'm sure those Asperger-like quirks don't explain the entirety of my cousin's personality. They're all just starting points.

[Angelskates]

I "label" my cousin so I know what he needs. So I can get an idea of where he's coming from.

But he doesn't have a diagnosis, so how does your lay-person diagnosis/label help you know what he needs, and where he's coming from? Even an official diagnosis/label can't do this. Can't you get to know him and learn this? IME, that's the only way to learn what he needs, and where he's coming from, much like anyone else, especially because you - his cousin, and not a psychologist or someone who has experience with kids with special needs - are giving him a label, and don't fully understand what that label means; and it means something different for each child. I don't understand why you need to tell yourself he's "very likely" got Aspergers in order to be patient with him.

This is a pet peeve of mine, lay people (mostly parents and teachers) telling themselves a particular child has a LABEL in order to show compassion, empathy, patience etc. or make it "okay". We shouldn't need to label to accept those with differences, but I think it's even more problematic when those not qualified to label are "labelling" in order to try and explain something to themselves or make sense of a behaviour, rather than just accepting, or working with, the behaviour. Maybe he doesn't need special treatment because he doesn't have autism/Aspergers, and has a quirky personality. I don't know. But without a diagnosis, neither do you. Yet you feel the need to label him as very likely having Aspergers. Can you explain more of why/ how this helps you? And how you think it helps him?

I do understand if there is an official diagnosis, you could research that and see in general terms some things that may help you understand your cousin, but with a diagnosis given a lay person, I don't understand. (Actually i often don't understand with official diagnoses as well, unless they're needed for school or insurance.) The traits are just that, traits. Found in many people, autistic and not, and getting to know your cousin as a person would help you understand what he needs, just like with any other person.

[michiruwater]

If 50% of the population is introverted, and 50% of the population, by your definition, therefore have 'mild autism'... I mean, that's as many people having 'mild autism' as are male. You seriously cannot look at that and realize how ridiculous it sounds? Autism is a mental illness that needs treatment. You just labeled Angelskates and me as autistic when we are not autistic, thus depreciating the severity of the disease for those that actually have to deal with it every day. It's extremely offensive.

'Mildly autistic' does not help explain why Angelskates or I are the way we are. 'Introverted' does. The two are not synonyms.

[PDilemma]

God, no. I'm an introvert, crowds do bother me. I have sensory issues, but I am not autistic. Plenty of people have some autistic traits/tendencies, but it doesn't make them "slightly autistic". This is the thinking that has society in trouble, IMO, everything needs a label. You're either on the autistic scale, or you're not. There's not such thing as slightly autistic, any more than there's "a little bit dyslexic" or "a bit ADHD". You're your own normal, and everyone is different.

I think, though, that we are in danger of getting to a place where there is a standard and defined normal (in the U.S. that definition will include extroverted traits) and anyone outside it is expected to be labeled with some "disorder" or another. Like PL, I was beginning to see every parent of a slightly quirky kid seeking a label for them and every other parent with a kid not making straight A's wanting them tested for a learning disability. We are not leaving a lot of room for people to be their own normal anymore.

(ETA: I hope this doesn't sound like I am disagreeing with anything you said...I'm just adding an extended thought...reread it and it sounded like I was, sorry!)

[Stormy]

If 50% of the population is introverted, and 50% of the population, by your definition, therefore have 'mild autism'... I mean, that's as many people having 'mild autism' as are male. You seriously cannot look at that and realize how ridiculous it sounds? Autism is a mental illness that needs treatment. You just labeled Angelskates and me as autistic when we are not autistic, thus depreciating the severity of the disease for those that actually have to deal with it every day. It's extremely offensive.

'Mildly autistic' does not help explain why Angelskates or I are the way we are. 'Introverted' does. The two are not synonyms.

Very well said, Michiru! I can't agree with you more.

[Angelskates]

I think, though, that we are in danger of getting to a place where there is a standard and defined normal (in the U.S. that definition will include extroverted traits) and anyone outside it is expected to be labeled with some "disorder" or another. Like PL, I was beginning to see every parent of a slightly quirky kid seeking a label for them and every other parent with a kid not making straight A's wanting them tested for a learning disability. We are not leaving a lot of room for people to be their own normal anymore.

(ETA: I hope this doesn't sound like I am disagreeing with anything you said...I'm just adding an extended thought...reread it and it sounded like I was, sorry!)

I agree with you. I see: problems with reading, writing or spelling = dyslexia, problems with keeping still, or being "naughty" in class = ADHD, introverted, "quirky", not many friends = Aspergers, very shy, doesn't like to talk = selective mutism. Problems with communicating and making friends = autism. These labels are thrown around far too much, by people who don't understand them. I work in a multi-lingistic, multicultural environment (which is my area of study and expertise - the relationships between this and special needs, and working with them both together) and many, if not all, of these issues can be caused but a lot of other things, including cultural and linguistic confusion/discomfort and too much information and/or change. Or they could not be the child's strengths, or just part of their personality. I think it's a shame that people feel the need to label - and a lot of the time it's because they don't want to modify their own behaviour, or they need a reason to, or because they want me to fix it

[MacMadame]

I think, though, that we are in danger of getting to a place where there is a standard and defined normal (in the U.S. that definition will include extroverted traits) and anyone outside it is expected to be labeled with some "disorder" or another.

I think we're already there. Okay, not 100% there. But we're close in a lot of ways.

I think there are a lot of pressures that cause this. Parents do want a quick fix sometimes. But sometimes they see their kids struggling and what they do doesn't help and so they want to both find out what's wrong and also take possibilities off the table. (Like if there is a *slight* chance your kid has something then it will keep coming up even if it's unlikely and testing can narrow the choices so that the unlikely doesn't keep coming up to cloud the issue.)

Another pressure is for schools who are required (or want to in places it's not required) to make accommodations. Having everyone with a label makes their lives easier because they can develop some protocols and shoe horn you into them. Even if they are willing to deal with people individually, having a label helps them not start from scratch.

There are also organizations who want more recognition for their particular disorder and more people being diagnosed with that disorder helps them fund raise and get legislation and other things they want and even need.

Finally, I do think it's human nature to label things. It's kind of how we understand the world by categorizing and putting things in boxes.

[Anita18]

If 50% of the population is introverted, and 50% of the population, by your definition, therefore have 'mild autism'... I mean, that's as many people having 'mild autism' as are male. You seriously cannot look at that and realize how ridiculous it sounds? Autism is a mental illness that needs treatment. You just labeled Angelskates and me as autistic when we are not autistic, thus depreciating the severity of the disease for those that actually have to deal with it every day. It's extremely offensive.

'Mildly autistic' does not help explain why Angelskates or I are the way we are. 'Introverted' does. The two are not synonyms.

I never said that I agreed all introverted traits were from autism. I just said there was an article I read that mentioned it, and gave me food for thought. But from what I've observed, some people are different introverted than others. The introvertedness can stem from different things. It's really just that everyone's different, and people have different ways of categorizing their personalities to possibly help explain how they work.

Giving my cousin the casual label of Asperger's does not help him. I fully admit to that. He's doing well on his own, he has people looking out for him. I would not dare suggest that he needs special treatment. It's simply a starting point to help me understand why he might be the way he is. It's not like I'm going down the list of "what to do with an Asperger's kid" to find out how to interact with him.

[Angelskates]

Giving my cousin the casual label of Asperger's does not help him. I fully admit to that. He's doing well on his own, he has people looking out for him. I would not dare suggest that he needs special treatment. It's simply a starting point to help me understand why he might be the way he is. It's not like I'm going down the list of "what to do with an Asperger's kid" to find out how to interact with him.

And this is a shame, that you need that casual label. Not just you, but so many people feel the need to throw labels around in order to help understand others, when really lay labels mean absolutely nothing except make the labeller feel better and supposedly give them a way of trying to understand that is, sadly, more socially acceptable than saying "different". It does nothing for the person being labelled, except put them in a box. How is the label a starting point to helping you understand? You really don't know that he has Asperger's, but you've told yourself he does. Can you explain how that helps you understand why he might be the way he is? I am really curious...

[michiruwater]

But from what I've observed, some people are different introverted than others. The introvertedness can stem from different things.

Can you please explain what you mean by this? In what way are people introverted differently? What different things can introversion stem from?