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Asperger's to be classified as autism in new mental health bible

A condition popularly associated with quirky geniuses and child prodigies may be disappearing from the diagnostic bible of psychiatry, much to the relief — and sometimes frustration — of those dealing with Asperger's syndrome.

The American Psychiatric Association proposed on Wednesday to place the disorder — characterized by traits such as problems with social interactions — on the mild end of the autism spectrum. The change is one of several meant to better reflect current knowledge about diagnosing and treating Asperger's and autism.

But it would do away with a diagnosis that is linked to intellectual titans like Albert Einstein and Emily Dickinson.

Joshua Houglum, a 32-year-old Clearwater computer technician, was diagnosed with Asperger's just last year after longtime struggles with social interactions. Although some fear the change could stigmatize patients by rolling high-functioning people in with those who are more severely disabled, Houglum applauded the move, saying it's a better way to talk about a condition with a wide range of characteristics.

"In the media, you either see somebody who's really struggling or somebody that's a math genius, and there's a lot of gray area in the spectrum," Houglum said. "Having it labeled as autism and then really the defining characteristic being the severity of the symptoms, that's a more accurate description."

Michael John Carley, executive director of the Global and Regional Asperger Syndrome Partnership, acknowledged the difficulty in a definition that lumps together a socially awkward lawyer with a severely disabled person who needs diapers and head protection.

"I personally am going to find it a little weird to refer to myself as autistic," said Carley, author of Asperger's From the Inside Out. Still, he believes the change will prove a step forward for all. "If it pushes us to accept that these are variations of the same condition, I think that's good."

But the proposal upset some students in their early 20s at the Learning Academy, a transitional program at the Center for Autism and Related Disabilities at the University of South Florida in Tampa.

"A cold and a sinus infection both cause a runny nose, but they are not the same thing," Justin Hero told his teacher, Susan Richmond, whose students were shocked at the label change. A change in terminology won't change who he is, Hero said.

"I've been told that I have Asperger's since the sixth grade — what's the difference now?"

• • •

For health professionals, the expanded definition could lead to better diagnoses of autism, which affects an increasing number of children but in many cases remains poorly understood.

Autism spectrum disorders encompass a wide range of social impairments and communication deficiencies now often diagnosed in early childhood.

Children with Asperger's do not have the language deficits associated with more severe displays of autism, noted Eric Storch, an associate professor in the departments of pediatrics and psychiatry at the University of South Florida. But current definitions can miss children elsewhere along the spectrum who don't meet Asperger's criteria.

"Some kids with autism can be profoundly impaired. Some kids with autism can be hugely, wonderfully intelligent," said Storch, an autism researcher. "It really kind of says that these are symptoms that we believe are grouped together, but people can have varying levels of them."

• • •

Florida schools already include Asperger's syndrome within the autism spectrum for educational purposes. But the change could make additional resources available to Asperger's children, said Dr. Mark Cavitt, medical director of pediatric psychiatry at All Children's Hospital in St. Petersburg.

On the flip side, he noted, some may not want to be called autistic.

"There may be some negative stigma to having an autism diagnosis versus having Asperger's disorder," Cavitt said of the patients and their parents who "may feel they are being labeled with a more severe diagnosis."

For Hernando County mother Stacy Walsh, a big book of health conditions isn't going to change what she knows about her 11-year-old son, Gavin, diagnosed with Asperger's syndrome and as a high-functioning autistic child.

"The changing of the definition is probably a formal thing, but in the field that's already been accepted for a long time," said Walsh, co-director of Special Students of Hernando. "It's overdue."

Letitia Stein can be reached at lstein@sptimes.com or (813) 226-3322. For more health news, visit www.tampabay.com/health.

FAST FACTS

Major changes to
mental health bible

The revised definition of Asperger's syndrome is part of a sweeping update to the classifications of mental health disorders for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Other significant changes would redefine how health professionals are diagnosing childhood bipolar disorder and add categories like binge eating and behavioral addiction. Now available for public comment, the proposed categories can be viewed at www.DSM5.org. They will be refined over the next two years.

Asperger's to be classified as autism in new mental health bible 02/10/10 [Last modified: Thursday, February 11, 2010 11:52am]
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