Autism spectrum?

Recently the Star Tribune published an article about the reaction from members of the Asperger’s community (“Aspies” as they call themselves) toward the proposal to combine the diagnoses of autism and Asperger’s syndrome into a single category of “autism spectrum disorders” in the DSM 5. There is heated debate on both sides of this decision for many reasons, but to me it seems that there simply isn’t enough information about autism treatment, let alone evidence that this will improve the ability to diagnose and treat Asperger’s, to make this change.

The recent article “Aspies cling to Aspergers as an elite diagnosis” brings to light an important issue—the medical and social struggle with ever increasing rates of autism in the US and the question of how we should diagnose and treat the range of autism-related disorders. However, I’m concerned that this article doesn’t address some very key questions we should be asking in response to this proposal. After considering some of the practical and political issues around it, I find myself wary of the American Psychiatric Association’s proposal to put Asperger’s syndrome under this spectrum in the DSM 5. The focus of this issue, though, should not be the vague consequences for “Aspie” identity, but why this is being considered and what practical impact it will have. The fact that many Aspies are fighting this raises the question of where the benefits of this change will land. In discussing the reasoning behind the consolidation, the article states: “doctors use the term [autism] loosely and disagree on what it means, according to psychiatrists urging the revisions.” If we group this comparatively mild syndrome mostly impairing social function with much more serious disorders, what kind of changes will we see in psychiatrists’ recommendations and prescriptions for its treatment? This leads to the question of whether we are even treating autism effectively—if not, how exactly will this change bring benefit to people with Asperger’s? Currently there seem to be enough problems with the treatment of autism and too much that we don’t know about it to complicate its definition further. We need to address these questions before making changes to the DSM that could have major unexpected consequences.