Archive for February, 2010

The American Psychiatric Association wants to include what is currently known as Asperger’s Syndrome in the same category or classification as autism and other pervasive developmental disorders (PDD’s). As a person with Asperger’s Syndrome I felt confused and angry when I first found this out. I found out when I saw a tweet from CNN’s Anderson Cooper.  How in the world can this make any sense? While Asperger’s Syndrome (AS) is on the autistic spectrum there are vast, notable, and important differences between AS, classic autism, other PDD’s, and even autistic spectrum disorder (ASD). What do you think? I can’t understand how this will benefit anyone, least of all those with Asperger’s Syndrome.

(CNN) — “People with Asperger’s syndrome would be included in the same diagnostic group as people with autism and pervasive developmental disorders, according to new guidelines under consideration by the American Psychiatric Association.

Psychiatrists are in the process of revising the guidelines, known as the Diagnostic and Statistical Manual of Mental Disorders. The manual has implications for how psychiatric drugs are developed and prescribed, what treatments get covered under insurance plans, which approach doctors take in treating their patients, and how patients view their own identities.

Anyone who has received a diagnosis from a mental health professional has most likely had his or her symptoms defined by the guidebook.

The revisions, which will be considered for the DSM’s fifth edition, due in 2013, were made public Wednesday at DSM5.org.

Scientifically, the distinction is correct; the research on people with these conditions has shown that Asperger’s is on the mild end of the spectrum of autistic disorders, said Dr. Michael First, professor of clinical psychiatry at Columbia University, who worked on the version of the DSM that is currently in use.

Of concern is that Asperger’s has been destigmatized and autism has not, he said. Over the past 15 years, communities have formed around Asperger’s, and the condition has taken on more positive tones with the notions that Albert Einstein and other intellectual luminaries may have had it.

Given that Asperger’s has become more acceptable, First favors keeping it as a diagnosis.

“This is a case where the science of the decision and social ramifications of the decision are separate,” First said.

But the DSM does not make diagnoses based on the stigma of one group over another, said Catherine Lord, director of the University of Michigan Autism and Communication Disorders Center, who is on the American Psychiatric Association committee looking at autism.

“Many people prefer to use the term Asperger’s, and we’re not saying that you can’t describe yourself that way,” she said. But the research shows “no scientific evidence that there are separate syndromes.”

 Source: CNN Health

Catherine Lord,(member of the American Psychiatric Association committee looking at autism) quoted above, by CNN, said, “… the DSM does not make diagnoses based on the stigma of one group over another” and that “… the research shows ‘no scientific evidence that there are separate syndromes.’ “ Well, might be too commonsense to actually consider anything to do with the stigma or how it can effect countless lives right? I am not sure that anyone has tried to argue that Asperger’s and classic autism or ASD are “separate syndromes”. I think appropriately the distinction that was made, and I think that needs to continue to be made, has all to do with degrees of the autistic spectrum. After all it has long-since been referred to as a spectrum with understandable reason. That is not the same as trying to say they are separate. However, how on earth can anyone then define them or classify them as the same just because they can say there isn’t any ”scientific evidence” to prove they are separate? Say what?

This leads me to wonder what is really behind this. I say that because Lord’s “reasoning” doesn’t seem very sound. To say that AS is the same as autism – or should be classified that way – defined that way – diagnosed that way – because there isn’t any “scientific evidence” that they are separate syndromes flies in the face of the vast differences that have been identified and acknowledged for some time now. Differences that matter. Differences that help people to understand themselves and to learn to cope with all that they have to cope with. Differences that do, I think, negate the sameness that would justify lumping them together or merging them.

What could be helpful about going backwards in definition, experience, and understanding?

And it gets worse really, also quoted by CNN on Anderson Cooper’s 360 Blog: “Dr. Charles Raison, psychiatrist at Emory University, acknowledged that “autism” is a “frightening word,” and that moving Asperger’s under autism may pathologize it more. Still, it is more accurate to call it a form of autism, he said.”

So, despite pathologizing those of us with Asperger’s Syndrome more, Dr. Raison believes that being more accurate and merging the DSM definition is more important. Who will this possibly benefit? In fact, I know as someone with AS myself, that many of us actually work with and talk often with parents of children with varying degrees of autism on the spectrum up to and including classic autism and that the fact that Asperger’s has made it somewhat out from under a lot of stigma and pathologizing to be more understood - not just negatives but strong positives too –  long enough to help others understand and to give hope that the autistic world (worlds really) can often, one way or another, to one degree or another, connect with the neurotypical (NT) world.

It’s just that no matter what you classify all of us as, we can’t, and many don’t want to anyway, conform to NT thinking. This means that neurotypicals need to stop trying to change their aspie or autistic kids (adults even) into NT’s. It’s just not in the hard-wiring. Difference needs to be respected. What NT’s define as disability is truly a different ability – perhaps one NT’s still don’t well understand. For all the really brilliant, creative, and innovative people throughout history identified as likely having had Asperger’s Syndrome, NT’s – yes even the people on the DSM-V committee – need to ask themselves where would the world be without the tremendously valuable contribution of many with Asperger’s Syndrome whose brains were, thankfully, wired differently?

I think it reasonable to conclude that this proposed merger of Asperger’s Syndrome with Autism and PDD’s is to serve some function or purpose for those who define things and diagnose things. It can’t possibly be being forwarded to help anyone on anywhere on the autistic spectrum.

The revisions are being considered for the DSM’s fifth edition, due in 2013. They were made public Wednesday at DSM5.org, and are available for public comment until April 20, 2010. I would sure urge anyone who, like myself feels very strongly that this change does not make any sense at all to let this committee know how you feel. Every voice counts.

If they make this change it will cause a tremendous amount of confusion. I don’t think people with Asperger’s Syndrome (AS)  aren’t aware that AS is a form of autism and that it is described as milder and has its own traits. Traits which of course not all people with AS have in the exact same ways or numbers or to the same degree.

However, to think that if these changes are made in the DSM-V that someone like myself would be labelled autistic right along with someone who has classic autism or another form of a pervasive developmental disorder (PDD) (no disrepect meant to these groups of people) the result could only be massive confusion from all who are not professionals. It would also mean that the ground gained in that Asperger’s Syndrome has travelled out of that abyss of stigma would be compromised at best and perhaps lost at worst.

It would mean being even more misunderstood than people with AS are now.  It might also lead people with relatives with classic autism to question why their loved ones are one way and many of us are quite different – if we were all diagnosed or “labelled” the same. It would likely also mean that many with AS will have a much more difficult time finding appropriate services. For adults and women with AS in particular it may just leave us even more invisible in terms of any support or help that many need than has been the case to date.

What do you think? If you have Asperger’s Syndrome, or a loved one with it, does this make any sense to you? Do you want to have to try to explain to people that you have autism? Can’t you just hear it now? Who will understand? How can this be a positive change for anyone?

© A.J. Mahari, February 12, 2010

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Asperger Syndrome is an Autism Spectrum Disorder (ASD). It was first included in the Diagnostic and Statistical Manual (American Psychiatric Association) under the general category of Pervasive Developmental Disorders (PDDs) in 1994. It is named after Hans Asperger, of Vienna, who wrote about this cluster of characteristics as early as 1944. Are self help principles, ideas, and practices effective for people with Asperger’s Syndrome?

• “Many individuals with Asperger Syndrome exhibit extensive knowledge of a specific interest and therefore are capable of major accomplishments.
• Although Asperger Syndrome can be first detected in childhood, many individuals are not diagnosed until well into adolescence or adulthood.
• The cause of Asperger Syndrome is not yet established, but a leading theory at this time points to genetic causes. Many individuals diagnosed with Asperger Syndrome identify similar traits in their family members.” 

             Source: Aspergers Society of Ontario

You might think well, if Asperger’s Syndrome is genetic and on the autism spectrum and since it is a pervasive developmental disorder that that may mean there’s nothing that can be done to help someone.  For those of us diganosed in adulthood there are even more challenges because any chance for early intervention, counselling, psycho-education, social skills training and so forth has been missed. And, once in adulthood there are very few places one can go for this assistance, if you can find anywhere at all that works with adults.  Most of the resources used in treatment and managing Asperger’s Syndrome (AS) are in place only for those under the age of majority. So, are you just stuck with it? How can you change anything when there isn’t a way to actually get rid of it? Mind you, most aspies I know, and I include myself here, would not want to get “rid of it” even if it was possible to do so.

Not everyone diagnosed with Aspergers is the same. Not everyone diagnosed with Aspergers has all the traits or has certain traits as strongly as the next person. It is important, if you are an adult with AS, to look at what your strengths and weaknesses are. For many with AS common strengths include a high intelligence and strong interest in a least one area of narrow focus. While this narrow focus can have its drawbacks it can also be harnessed as quite a strength in many ways. An obvious and quite common so-called weakness for those with AS is social impairment. However, I have come to realize that the way that is defined is very genernalized. Each one of us needs to examine our own abilities and challenges in this area particularily. I say so-called because to the degree to which one is socially impaired or not can depend quite a bit on your own idea of what that means for you as an individual.

One of the major aspects of self help that can be of great assistance to those with AS is learning more about self-acceptance and respecting differences, to the degree that you understand the ways in which you are different from the average NT. Even if NT’s around you don’t understand or respect your differences its important to not take on the judgment or misconceptions of those who cannot understand what its like to have AS. NT’s are often very confused by a lot of the ways in which we think. Just as those with AS find many of the ways that NT’s think a little other-worldly too. It is equally important to realize that a lot of what we do differently, or the ways in which we may think differently, can be positively framed in realizing your capability to function in and through what is a different ability.

I have come to realize in my own life that having AS doesn’t mean, for me in my life, that I am disabled. I am differently abled. I may have many differences in how I function – known as aspie lack of executive dysfunction – which I have found through my own self help efforts can really be transformed into different ways of functioning. Again, the key is changing the way you think about difference and being the one that is different. What NT’s call dysfunction can be turned into your own undersanding of many different ways that you actually do function – this aspie functionality is just not well understood by NT’s and of course is not the same as NT functioning.

You really can create change in your life like anyone else – like your neurotypical (NT) counterparts. Change for some with Asperger’s means personal growth and evolution in understanding and learning for many. For some it might be more about finding productive and workable compensatory strategies. Social strategies are also important to explore and implement. They can take practice. However, if you learn to be kind to yourself and avoid judging yourself you will find that what you practice and what you apply from self help philosophy can and will be very helpful.

As a life coach I have learned to apply self help strategies in  my work with many clients with Asperger’s Syndrome. I have, of course, also learned to apply much of these same self help strategies in my own life. The first step in ensuring that you can make the most out of the self help you can learn much more about is to have an open mind about how much you can empower yourself to find ways to cope and ways to compensate for what isn’t exactly entirely changeable. Adaptation is a key facet of applying self help to your life journey with Asperger’s Syndrome.

 ©  A.J. Mahari, February 5, 2010 – All rights reserved.

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There are many challenges experienced by people with Asperger’s Syndrome. Many of these challenges are heightened in the area of socialization. Each person with Asperger’s Syndrome has his or her own set of unique challenges despite the common traits associated with the diagnosis. One of the main challenges for adults with Asperger’s is just to be able to become aware of what the challenges and differences of having Asperger’s (AS) are. Some with AS are more able to be made aware of and learn about these differences and the compensatory strategies that can help.

The most central challenge of being an adult with Asperger’s Syndrome is self-acceptance. Closely followed by radically accepting what having AS means in terms of being different from those who don’t have AS – neuro-typicals (NT’s).

It is important to realize that as aspie’s it can seem like there is this NT-everyone else out there, as if all NT’s are alike or as if all NT’s have the same abilities or levels of functions – they aren’t all alike and they don’t all have the same level of function at all.

It can seem like you are marginalized if you have AS, and even moreso for women with AS. The truth about that is just that there are more NT’s than there are those of us with Asperger’s. Having a practical radical acceptance of how that tends to create and for some support their stereotypes can mean giving yourself the gift of not twisting yourself into an upset pretzel at that the reality that you are different from someone who is NT. We have to remember that the differences aren’t all stacked against us. In fact, having Asperger’s does mean having some unique skills and in most cases a very high IQ.

©  A.J. Mahari, February 1, 2010 – All rights reserved.

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