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Monday, June 4, 2018

The Unintended Consequences of DSM in Australia

Australia's National Disability Insurance Agency may cut off support for autistic people with "level 2" severity u nder DSM-5 ("requires substantial support").  Rick Morton at The Australian quotes Andrew Whitehouse, chief research officer of that country's Co-operative Research Center:
“That first inclusion really only described people who were clearly affected but it prompted a huge amount of research that found the behaviours used to diagnose ­autism can be there even when there is no intellectual disability or language impairment,” Whitehouse says.
“So when the DSM-IV came around in 1994, that was really the tipping point because that ­included all these other conditions such as Asperger’s syndrome, ­autistic disorder and pervasive ­development disorder — not otherwise specified, which is a frighteningly broad term.”
The thinking changed again in 2013 when the fifth edition came out and experts decided there was “no validity in differentiating the conditions”, so they were collapsed back under one umbrella.
As if to underscore the unpredictability of it all, the three levels of autism were added to the ­umbrella to provide some room for movement, but Whitehouse says they ought to be nothing more than a “shorthand descriptor” for clinicians. “They were never designed to be used, and nor should they be used, to apportion support for people with autism."