It’s high time we put the most enduring myths about human behavior to bed, and see the mind—and the world—as it is.
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I watched your presentation in the IACC committee and was impressed by it. I noticed you were still questioning the place of Social Communication Disorder as classified in the DSM5 final revision. While I provided information from Wiki that SCD is classified as a Communication Disorder, the APA has officially released the table of contents for the final revision of the DSM5, and SCD is indeed listed as a communication disorder, per the link provided above.
I noticed recently that Michelle Dawson's interpretation is that Social Reciprocity Disorder in the ICD11 latest beta revision, that is replacing Asperger's syndrome and remaining an Autism Spectrum Disorder in the ICD11 beta version current revision might be coded as social communication disorder per DSM5 standards.
However that does not seem logical as social communication disorder is a disorder of pragmatic communication, not a disorder of social reciprocity as described in the ICD11 beta definition, which precludes severe language impairments.
The definition of Asperger's exists in the ICD10, but exists only by crosswalk of code in the ICD9CM that is still used in the US for coding purposes. There is no reason why the ICD11 will not use the same procedure in identifying SCD as a communication disorder in the ICD11 in the coding section, even though there likely will be no definition in the finalized ICD11 manual for SCD.
If a similar SCD communication disorder is approved between now and the time the ICD11 is finalized, it will obviously be classified in the Communication Disorder section of that ICD11 manual.
A long term issue is that neither the ICD10 or DSMIV ever described the different syndrome of Asperger's syndrome, that Hans Asperger described in his paper in 1944 as "Autistic Psychopathy". The Gillberg Criteria is the only criteria that does that, the only place where what Hans Asperger described in his case studies effectively exists per diagnostic criteria.
Asperger's Syndrome has effectively been described as "Autism Lite" all along in the ICD10 and DSMIV as the choice was made not to include the language impairments that were a core part of what Hans Asperger described in his case studies along with difficulties in social-emotional reciprocity, restricted areas of interest, adherence to routine, non-verbal impairments, developing and maintaining peer appropriate relationships and motor skills difficulties.
The ICD10 and DSMIV decided instead to eliminate the verbal impairments in communication, descriptions of developmental delays, and reduction in the number of optional criteria required in the areas of RRBI's and Social Interaction identical to both described disorders of Autistic Disorder and Asperger's syndrome. That is not Autism Different it is "Autism Lite", and a major reason why Asperger's syndrome will no longer exist in either diagnostic manual, because it never fully existed in the first place in those manuals.
Even if the ICD11 beta definition of Social reciprocity disorder and the DSM5 definition of Social Communication Disorder were combined it still would not adequately describe the autistic condition that Hans Asperger described in his case studies.
And the DSM5's decision to no longer focus a criteria category on communication in verbal language impairments no longer effectively describes what either Hans Asperger or Leo Kanner described as autistic conditions, in their case studies.
Here is the ICD11 beta continued revised version. It is surprising to me that the synonym of Asperger's Syndrome is even associated with it, as it has basically been watered down to one criterion element of what Hans Asperger's described.
"Social reciprocity disorder [Asperger syndrome]
Autism spectrum disorders
Social reciprocity disorder is characterised by persistent impairment in social reciprocity that is not usually accompanied by general intellectual impairment, severe language impairment or epilepsy. The limited ability to engage in reciprocal social interactions substantially constrains the roles the individual is able to take in society. Features of this disorder are manifest in early childhood but the impairing nature of this condition may be more obvious in later childhood, adolescence and adulthood. This category is specified as needing further testing."
The ICD10 and DSMIV could have just labeled what they described as Asperger's syndrome as PDDNOS 2.0. The DSM5 definition of ASD has effectively become PDDNOS 3.0 with only one consolidated criterion with 3 elements required observed and identified for a diagnosis now that Sue Swedo, the Chair of the DSM5 working group, has identified on the APA website that RRBI's may be met by historical account of caregiver or patient alone, as linked below.
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