26 January 2012

DSM-V and all that nonsense

Well crap. I thought I'd posted this on Monday. I guess not. Anyway, here it is:

The Autism community is freaking out this week about changes to the autism diagnosis, and I can't say that I blame them. The high-functioning folks are worried that they'll test out - that is, be too high functioning for diagnosis and by extension, services. The low-functioning folks are worried that their autism symptoms will be attributed to their intellectual disability and not vice versa. So, for example, Jim has low-functioning autism and an IQ of 50. Jim's autism isn't caused by his low IQ, but some of the symptoms, like inability to understand complex directions, could be attributed to it. Enough of that goes on, and he tests out of autism and into developmentally disabled, mentally retarded, intellectual disability. Everyone is scared.

A classic autism symptom: lining up objects
And why not? It's not like the services we get now are even close to enough. The schools are terrible at accommodating our children now. Take their diagnoses away and there's no funding. No funding, no IEPs, no aides. No fun for anyone. And services for adults? Even worse. Just try living on the paltry sum the government deigns to give you for disability. $750/mo here in BC. Considering the average price of a 1 bedroom apartment is about $675, good luck. Especially if you need meds. Or enjoy eating.

I'm not overly concerned for the low-functioning folks. Reason being, I think the latest versions of the proposal took out the clauses about the symptoms not being otherwise explained by other developmental disabilities - that's where their worry was. I'm pretty sure they're not going to get squeezed out. The Aspies? Maybe. There might be issues there. My Aspie would certainly still qualify. Pop? Maybe not. But that's because of extensive biomedical interventions. Remove those and his symptoms intensify considerably.

There are several problems with autism diagnosis. 1) It's very hard to differentiate between unusual and abnormal. Where is the defining line? 2) It's a spectrum disorder. Everyone is different. No two people with Autism are identical; 3) There seem to be a number of underlying causes of autism. Some people have mitochondrial dysfunction. Some have heavy metal poisoning. Some have genetic copies or deletions. Some have low folate levels in their spinal fluid. Etc. To me, this means there are dozens of different disorders causing a set of problems in the same areas of the brain. And that leads to the problem I think is the worst: 4) Autism is not a psychiatric disorder. It shouldn't be in the DSM at all. Autism is a neurological disorder. It is physical. It is biological. It is not brought on by trauma or abuse. (FWIW, there are a good number of "psychiatric" disorders that are neurological)

So why are they doing this? They claim that there are too many cases of autism now. That their diagnostic criteria were too broad. Um, or how about there are more and more cases of it because of the onslaught of environmental toxins causing genetic defects? Every. Single. Family. in my complex has at least one kid with an Autism Spectrum Disorder. It's bizarre. And then I remember we live next to a golf course that sprays pesticides all over the place all summer. You cannot redefine the disorder and have any kid change. It's like changing the poverty level and then congratulating yourself for lowering the poverty rate. The bottom line is that there is a larger number of disabled kids than ever and something needs to change. But it's not the diagnostic criteria.