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Effective May, Autism Will Be Described As "Autism Spectrum Disorder"

Posted by on Apr. 25, 2013 at 9:38 AM
  • 18 Replies

No more terms like PDD-NOS or Asperger's. Instead there will be 3 levels of severity per the APA DSM 5 release. This has been discussed for some time, but will be implemented as of May. I know there's been a lot of confusion for many parents, so this may be helpful. For example, my son would be Level 1. I'm not really what effect this will have with the whole autism society as a whole. 

Severity Levels for ASD

Severity Level for ASD

Social Communication

Restricted Interests & repetitive behaviors

Level 3 

‘Requiring very substantial support’

Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning; very limited initiation of social interactions and minimal response to social overtures from others.  

Preoccupations, fixated rituals and/or repetitive behaviors markedly interfere with functioning in all spheres.  Marked distress when rituals or routines are interrupted; very difficult to redirect from fixated interest or returns to it quickly.

Level 2 

‘Requiring substantial support’

Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions and reduced or abnormal response to social overtures from others.

RRBs and/or preoccupations or fixated interests appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts.  Distress or frustration is apparent when RRB’s are interrupted; difficult to redirect from fixated interest.

Level 1

‘Requiring support’

Without supports in place, deficits in social communication cause noticeable impairments.  Has difficulty initiating social interactions and demonstrates clear examples of atypical or unsuccessful responses to social overtures of others.  May appear to have decreased interest in social interactions. 

Rituals and repetitive behaviors (RRB’s) cause significant interference with functioning in one or more contexts.  Resists attempts by others to interrupt RRB’s or to be redirected from fixated interest.























What requirements will meet Autism Spectrum Disorders? 

American Psychiatric Association DSM-5 Development

(Retrieved from www.dsm5.org)

Autism Spectrum Disorder

Must meet criteria A, B, C, and D:

A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:

1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction,
2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and  in making friends  to an apparent absence of interest in people

B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:

1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases). 
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
4. Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

C.    Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

D.    Symptoms together limit and impair everyday functioning.



Read more: http://www.autismsupportnetwork.com/news/proposed-dsm-5-changes-regard-asd-3478294#ixzz2RTvTbFbF
by on Apr. 25, 2013 at 9:38 AM
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Replies (1-10):
DestinyRoseLC
by Bronze Member on Apr. 25, 2013 at 9:52 AM
My son is level 2
DestinyRoseLC
by Bronze Member on Apr. 25, 2013 at 9:53 AM
I'm wondering how this will effect services
tooptimistic
by Kelly on Apr. 25, 2013 at 9:55 AM

I think this is GREAT.  :)  I like the idea of having the levels.  My guy is between level one and two.

tooptimistic
by Kelly on Apr. 25, 2013 at 9:57 AM



Quoting DestinyRoseLC:

I'm wondering how this will effect services


I don't think it will effect services at all.  They all say "with support".

               If you ♥ to read check out my groups


DestinyRoseLC
by Bronze Member on Apr. 25, 2013 at 10:02 AM
I hope not. Dealing with services is already enough of a hassle :-\

Quoting tooptimistic:




Quoting DestinyRoseLC:

I'm wondering how this will effect services



I don't think it will effect services at all.  They all say "with support".

tooptimistic
by Kelly on Apr. 25, 2013 at 10:06 AM

Not trying to be nosy.. What kind of services is he receiving?

My son in six.  He gets OT twice a week and speech twice a week.  We were in peer therapy too, but that just seemed like a waste of time.  It wasn't very well executed.  He has been receiving services since he was two, without any issues.  :)


Quoting DestinyRoseLC:

I hope not. Dealing with services is already enough of a hassle :-\

Quoting tooptimistic:




Quoting DestinyRoseLC:

I'm wondering how this will effect services



I don't think it will effect services at all.  They all say "with support".



greenie63
by Silver Member on Apr. 25, 2013 at 10:09 AM
1 mom liked this

This may help; 


Will the change alter the number of people who will be funded to receive treatment services?

The DSM-5 committee’s proposed revisions will purportedly reduce the number of people diagnosed with Autism Spectrum Disorder but it also includes a new category through which they can potentially receive services.

There are two significant public funding models in the U.S. for students with social learning challenges.

One is allocated through state disability service departments that vary by name in different states. In California the funding flows through “Regional Centers,” in many states the funding flows through “Waiver” programs, and I am sure other states call this bucket of state and federal funding by a different name. This funding has never been based solely on a diagnostic label; there are criterion an individual must “pass” to be considered “disabled enough” to ultimately receive this type of funding. These past years have shown reductions in public funding and a tightening of who qualifies for these funds. The clients who will no longer be considered ASD under the new DSM-5 are the subgroup of clients who have not been guaranteed funding in the past given their “higher functioning” profiles.”  At present it is completely unclear how those students who currently qualify under the existing diagnostic system will fare, and how state/federal departments managing these funds will handle this change. Also unclear is how these entities will announce policy changes to the public. It will certainly be costly to re-assess all individuals currently diagnosed with an ASD!

The second major funding stream flows through the public schools, for students who are eligible for IEP or 504 plan services. Public schools are required to independently assess a student’s learning abilities and disabilities to determine if a student is eligible for special education under one of the 13 eligibility categories. Not everyone recognizes that a medical professional’s diagnosis does not directly translate into school special education services in the form of an IEP, even though this is federal law. One of the school’s eligibility categories in each state is Autism or it may be “autistic like.” The kicker is that each state gets to decide for itself what the eligibility criteria are for that category. Hence, a student may be considered “autistic” in one state but not in another, depending on how the state defines it. When a student is qualified for services under an eligibility category, these services are not determined by the eligibility category itself but instead by the individual needs documented in the IEP written for that student. Therefore, once a student is eligible for services it really should not matter which category he or she qualified under. Services should be driven by individual need as determined by the IEP team.

These shifts ask us to take a two-pronged approach to meeting the needs of our students with social learning challenges:

+ State departments of education need to start considering if their state’s eligibility category descriptions need to be revamped in light of the proposed DSM-5 changes. I know some states have eligibility descriptions that align directly with the DSM-IV while other states, such as California, never changed their eligibility categories with the recognition of Asperger Syndrome in the DSM-IV.

+ While it is clear that each state’s school district personnel will continue to determine if a student qualifies for services under these eligibility categories, we must recognize that school professionals can be influenced by the diagnostic reports from medical professionals in their community. To this extent, each state needs to proactively determine how to address and serve students who will now be diagnosed with the entirely new diagnostic category, Social Communication Disorder. If a student with that diagnosis qualifies for an IEP, what is the best education eligibility category to place that student in? Will schools modify their categories to include Social Communication Disorder (or SCD)? What it likely means is that even more students will be referred for speech and language services in the schools without the possible benefit of an “autism specialist.” Or perhaps schools will rid themselves of the term “autism specialist” and place students under the jurisdiction of “social communication specialists” to keep the door open so this broad range of students still receive some vital services to address their social communication challenges in the mainstream classroom, on the playground, etc.

How will this impact coverage for private services by insurance companies? 

Insurance companies in some states are being mandated to provide services for children with ASD.  It is likely that these insurance companies will take a definitive stance in refusing to cover services such as ABA therapy for those who are not “ASD” under the new definition. However, consider that many (not all, but most) clients who don’t fall into the DSM-5 ASD category are less likely to need the ABA model of treatment as they have developed language and need to learn a more complex (synergistic) set of communication skills that are beyond the more linear stair-stepped approach offered by traditional ABA programs.

Many insurance policies will consider covering a student who has mental health needs or social communication needs if the therapist can document the need for services and the benefit from services. However, insurance companies don’t cover anyone enthusiastically and they will try to find reasons (very often, not always) for refusing services. One significant issue with our clients is that insurance is very unlikely to cover our students as they transition into adulthood or live as an adult, as non-ASD neurodevelopmental disorders are not easily covered into adulthood, even though our students are showing great benefit from treatment as they transition and live as adults.




Quoting DestinyRoseLC:

I'm wondering how this will effect services


DestinyRoseLC
by Bronze Member on Apr. 25, 2013 at 10:13 AM
1 mom liked this
At the moment ot and sp.

Quoting tooptimistic:

Not trying to be nosy.. What kind of services is he receiving?

My son in six.  He gets OT twice a week and speech twice a week.  We were in peer therapy too, but that just seemed like a waste of time.  It wasn't very well executed.  He has been receiving services since he was two, without any issues.  :)



Quoting DestinyRoseLC:

I hope not. Dealing with services is already enough of a hassle :-\



Quoting tooptimistic:





Quoting DestinyRoseLC:

I'm wondering how this will effect services




I don't think it will effect services at all.  They all say "with support".




Euphoric
by Bazinga! on Apr. 25, 2013 at 10:14 AM

 bump

tooptimistic
by Kelly on Apr. 25, 2013 at 10:16 AM

Are you having insurance issues?  Our insurance has always been really great about our son's services. 

This may help.  :) 


Quoting DestinyRoseLC:

At the moment ot and sp.

Quoting tooptimistic:

Not trying to be nosy.. What kind of services is he receiving?

My son in six.  He gets OT twice a week and speech twice a week.  We were in peer therapy too, but that just seemed like a waste of time.  It wasn't very well executed.  He has been receiving services since he was two, without any issues.  :)



Quoting DestinyRoseLC:

I hope not. Dealing with services is already enough of a hassle :-\



Quoting tooptimistic:





Quoting DestinyRoseLC:

I'm wondering how this will effect services




I don't think it will effect services at all.  They all say "with support".






               If you ♥ to read check out my groups


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