Autism and the DSM-5: Diagnostic Criteria (Section E and Severity Levels)

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Autism and the DSM 5: Part 6 – Diagnostic Criteria: Section E and Severity Levels


5 responses to this post.

  1. Great summary. Regarding these severity levels and function labels, I see is as we have to understand what the sensory overloads are present at any given time for that particular person. For my son, I’m pretty sure the sensory overloads of middle school are what more or less lead him to develop the pattern of going almost mute in the school setting, but remain his usual more talkative self at home. (Pressures like a more rapid-paced class schedule, loud & unpredictable behavior from classmates who all going through their own developmental challenges with puberty, etc)

    Have you ever seen this TED talk with Eleanor Longden?
    She is talking of a time in her life when she “heard voices” (what people would commonly call a mental illness, nothing like autism, but something she said struck a chord with me) She mentions how much she valued a doctor asked her “What happened to you?” instead of the stigmatizing “What’s wrong with you?”.

    It sort of dawned on me that maybe with the fluctuations in severity levels of autism, it could be a matter of “What is happening to you?”. What stress is your brain under at this particular point in time? This could change from minute to minute or year to year. It seems much more polite to ask someone “what’s bothering you?” than “what is wrong with you?”. Schedule changes may be stressful because the fixed predicatable patterns and rigidity might be like a result of learning ways to avoid hypersensitive reactions to sensory input. So, even despite an absense of the original sensory sources, and say the only thing that changes is the order in which things are done, an autistic person could still be just as debilitated as if they were experiencing a sensory input overload. Same would go for schedule change or environment change that doesn’t allow for stimming – no particular hypersensitivity sources may be present, but self-soothing has become one of the necessary patterns that helps one function.

    All of this ‘understanding’ doesn’t make the hypo- and/or hyper-sensitivities ‘go away’ (like Ms. Longden was able to banish the voices from her head), but perhaps undersanding would help an autistic open up to some kind of self-acceptance? In some cases it seems like the process of blocking out certain sensory input has allowed for other unique thought processing patterns to develop – which in some cases could manifest as creative genius. (Silicon Valley etc). I’m probably talking about those where no intellectual disability is present. Is this where we diverge into Aspergers territory?

    Once again, I digress, but this series of yours examining the DSM criteria so closely just really got my wheels turning!!! Thank you again for sharing.

  2. This is brilliant. OK, I also feel flattered to be included as an example. Actually, I’m fangirling over it because I got mentioned by a really awesome blogger. It just makes me want to squee really quietly for a bit.


    OK, sorry for that. This post is also brilliant because I sent the link to a friend of mine who has a 14 year old son with “autistic traits” (all the diagnosis he has so far, he’s on a waiting list for further testing), and it’s moved my friend so much that he’s turned into an advocate! I mean for his son. He said that he finally has the tools and the knowledge now to challenge his son’s school on how they’ve been supporting him so far. Woohoo! So, you’ve made that boy’s life a lot better already, he’s got a very determined advocate now! Thank you. :)

    • awesome, awesome, and double awesome! Thank you!
      Helping make other people’s lives better is *exactly* why I write!

      And you were a great example, which is why I pointed you out (I was actually nervous about it, unsure whether it was okay to point you out or not!) because you were such a clear example of someone who qualifies for diagnosis and needs the assistance that can come with diagnosis but is at risk of not getting that diagnosis because DSM-5 is still so new and it takes so long for some clinicians to “get on the proper page.”

      Any news of that process, by the way? I’ve thought of you and wondered how it’s going and hoped things were moving along well.

      (And sorry to take so long to respond to comments. I kind of burned out my energy for a few days by over-doing things.)

      • Taking care of yourself takes precedence over comments. I consider comments to be self-sufficient entities, they *can* exist without replies. So please don’t apologise. :)

        I have a second diagnostic interview next Thursday, I’m working on some scripts to bring up the childhood thing then. I will also say that I didn’t feel comfortable bringing up my mother’s traits right in front of my mother, because I have no right to diagnose her. I do have some very hard suspicions though (and have talked these over with my neurotypical brother to confirm). I will also mention the changes from DSM-IV to DSM-V, because we’re not officially using it here yet but we do have a Dutch translation that will probably be implemented some time soon.

        And if they don’t want to listen, then I might simply try a new diagnosis once the DSM-V has been adopted. Hopefully this will be a good strategy.

  3. […] Autism and the DSM-5: Diagnostic Criteria (Section E and Severity Levels): Section E looks at other possibilities for the symptoms; severity levels are ways to measure the current severity of the symptoms in sections A & B (and they are to be measured separately, and are listed as fluid, potentially changing back and forth over time). Severity levels replace the “high functioning” and “low functioning” labels, which I suspect pleases a lot of my fellow autistics. It certainly pleases U.M. She has also posted the contents of “Table 2″, which lists the criteria for the severity levels. […]

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