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Thread: Doctors want to redefine autism; parents worried

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    Default Doctors want to redefine autism; parents worried

    http://enews.earthlink.net/article/h...a-926129de05ef

    Actually there isn't a fixed definition of what autism really is right now and no standard test or qualifications a patient must have to qualify as being autistic which makes diagnosing and counting cases difficult. It current covers a wide spectrum (hence the full title of Autism Spectrum Disorder) of symptoms The confusion about a definition is one possible reason that more and more kids are being diagnosed as being autistic. This is an attempt to try to better define terms of what it means to be autistic.

    LINDSEY TANNER
    From Associated Press
    April 05, 2012 2:48 PM EDT
    CHICAGO (AP) — One child doesn't talk, rocks rhythmically back and forth and stares at clothes spinning in the dryer. Another has no trouble talking but is obsessed with trains, methodically naming every station in his state.

    Autistic kids like these hate change, but a big one is looming.

    For the first time in nearly two decades, experts want to rewrite the definition of autism. Some parents fear that if the definition is narrowed, their children may lose out on special therapies.

    For years, different autism-related labels have been used, the best known being Asperger's disorder. The doctors working on the new definition want to eliminate separate terms like that one and lump them all into an "autism spectrum disorder" category.

    Some specialists contend the proposal will exclude as many as 40 percent of kids now considered autistic. Parents of mildly affected children worry their kids will be left out and lose access to academic and behavioral services — and any chance of a normal life.

    But doctors on the American Psychiatric Association panel that has proposed the changes say none of that would happen.

    They maintain the revision is needed to dump confusing labels and clarify that autism can involve a range of symptoms from mild to severe. They say it will be easier to diagnose kids and ensure that those with true autism receive the same diagnosis.

    With new government data last week suggesting more kids than ever in the U.S. — 1 in 88 — have autism, the new definition may help clarify whether the rising numbers reflect a true increase in autism or overdiagnosis by doctors.

    There is no definitive test for autism. The diagnosis that has been used for at least 18 years covers children who once were called mentally retarded, as well as some who might have merely been considered quirky or odd. Today, some children diagnosed with autism may no longer fit the definition when they mature.

    "We're wanting to use this opportunity to get this diagnosis right," said Dr. Bryan King, a member of the revision panel and director of the autism center at Seattle Children's Hospital.

    The revision is among dozens of changes proposed for an update of the psychiatric association's reference manual, widely used for diagnosing mental illnesses. The more than 10,000 comments the group has received for the update mostly involve the autism proposal, with concerns voiced by doctors, researchers, families and advocacy groups. A spokeswoman declined to say whether most support or oppose the autism revision.

    The group's board of trustees is expected to vote on the proposals in December, and the updated manual is to be published next year.

    Among the proposed changes:

    — A new "autism spectrum disorder" category would be created, describing symptoms that generally appear before age 3. It would encompass children with "autistic disorder," now used for severe cases, plus those with two high-functioning variations.

    A diagnosis would require three types of communication problems, including limited or no conversation and poor social skills; and at least two repetitive behaviors or unusual, limited interests, including arm-flapping, tiptoe-walking and obsession with quirky topics.

    — Autistic disorder and high-functioning variations — Asperger's disorder and PDD-NOS, or "pervasive developmental disorder not otherwise specified" — would be eliminated, but their symptoms would be covered under the new category.

    Asperger's kids often have vast knowledge about a quirky subject but poor social skills; PDD-NOS is notoriously ill-defined and sometimes given to kids considered mildly autistic.

    — Another new category, "social communication disorder," would include children who relate poorly to others and have trouble reading facial expressions and body language. A small percentage of children now labeled with PDD-NOS would fit more accurately into this diagnosis, autism panel members say.

    They say the changes make scientific sense and are based on recent research.

    Opponents include older kids and adults with Asperger's who embrace their quirkiness and don't want to be lumped in with more severe autism, and parents like Kelly Andrus of Lewisville, Texas. Her son, Bradley, was diagnosed with mild autism a year ago, at age 2.

    "I'm really afraid we'd be pushed out of the services we get," she said. That includes a free preschool program for autistic kids and speech and occupational therapy, which cost her $50 a week. The family has no medical insurance.

    Opponents also include a well-known Yale University autism researcher, Dr. Fred Volkmar, who was on the revision panel but says he was unhappy with the process and quit. "I want to be sure we're not going to leave some kids out in the cold," he said.

    Volkmar is senior author of a study suggesting that the revision would exclude nearly 40 percent of children with true autism. But members of the revision panel have challenged Volkmar's methods, saying he relied on outdated data from two decades ago.

    One major advocacy group in the field, Autism Speaks, said it is awaiting further research on the effects of the revisions before deciding whether to endorse them.

    Dr. James Harris, a panel member and founding director of the developmental neuropsychiatry program at Johns Hopkins University, said the proposal will provide a better label for children who really only have communication problems.

    "I don't want a child labeled as autistic, which suggests a chronic, lifelong problem, when he has a social communication problem that may get better if he has proper services and his brain matures," Harris said.

    Harris said these kids don't need intensive autism therapy but should be eligible for other types of special education typically offered in public schools.

    Dr. Daniel Coury, chief of developmental and behavioral pediatrics at Nationwide Children's Hospital in Columbus, Ohio, said parents have valid concerns because insurance companies and schools may not immediately recognize that children receiving the new diagnosis may need special services.

    "So there may potentially be a lag time where services would not be available," he said.

    He noted it is already difficult for many families to get costly autism therapy. Some insurers don't cover it, and many financially strapped school districts have cut special education.

    ___
    Last edited by Zippyjuan; 04-06-2012 at 02:12 AM.
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  3. #2

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    I agree with doctors decision to redefine autism,.

  4. #3

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    As with all things relating to the biology of humans evolution provides a rational framework for asking questions about and forming hypotheses about autism.

    I haven't yet read up on this specifically, but this seems a good start.

    http://www.epjournal.net/wp-content/...P092072382.pdf

    Conceptualizing the Autism Spectrum in Terms of Natural Selection and Behavioral Ecology: The Solitary Forager Hypothesis.

    Abstract: This article reviews etiological and comparative evidence supporting the hypothesis that some genes associated with the autism spectrum were naturally selected and represent the adaptive benefits of being cognitively suited for solitary foraging. People on the autism spectrum are conceptualized here as ecologically competent individuals that could have been adept at learning and implementing hunting and gathering skills in the ancestral environment. Upon independence from their mothers, individuals on the autism spectrum may have been psychologically predisposed toward a different life-history strategy, common among mammals and even some primates, to hunt and gather primarily on their own. Many of the behavioral and cognitive tendencies that autistic individuals exhibit are viewed here as adaptations that would have complemented a solitary lifestyle. For example, the obsessive, repetitive and systemizing tendencies in autism, which can be mistakenly applied toward activities such as block stacking today, may have been focused by hunger and thirst toward successful food procurement in the ancestral past. Both solitary mammals and autistic individuals are low on measures of gregariousness, socialization, direct gazing, eye contact, facial expression, facial recognition, emotional engagement, affiliative need and other social behaviors. The evolution of the neurological tendencies in solitary species that predispose them toward being introverted and reclusive may hold important clues for the evolution of the autism spectrum and the natural selection of autism genes. Solitary animals are thought to eschew unnecessary social contact as part of a foraging strategy often due to scarcity and wide dispersal of food in their native environments. It is thought that the human ancestral environment was often nutritionally sparse as well, and this may have driven human parties to periodically disband. Inconsistencies in group size must have led to inconsistencies in the manner in which natural selection fashioned the social minds of humans, which in turn may well be responsible for the large variation in social abilities seen in human populations. This article emphasizes that individuals on the autism spectrum may have only been partially solitary, that natural selection may have only favored subclinical autistic traits and that the most severe cases of autism may be due to assortative mating.
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  5. #4

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    Fox-Tv's show "TOUCH" on Thursdays
    has story~arc'd around the ambiguities






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