Autism Spectrum Disorder (ASD) commonly known as Autism is mostly known for the ample variety of challenges in social skills, repetitive behaviors, speech and non-verbal communication. However, every person in the autism spectrum is different from another making them unique. Just as they have challenges, they also have their strengths sometimes even higher than typical peers, about a 10% even show savant skills. These combinations of highs and lows and places each of them in different parts of the spectrum. For many in the community this reflects neurodiversity.
Some people think that Asperger’s Syndrome and Autism are different and others that Asperger is part of the Autism (ASD). The confusion is based on who do you ask, and in what year this person obtained their knowledge on the matter and how up to date they keep themselves on the subject.
To understand this better we would need to know about the manuals professionals use to make their diagnosis. The Diagnostic and Statistical Manual of Mental (DSM) is currently in its 5th version and the International Classification of Diseases Manual (ICD) is currently in version 10, note version 11 is in the process of being reviewed.
In DSM (4th) Autism and Asperger were separated in their own categories under the Pervasive Developmental Disorders section. However, since 2013 the American Psychiatric Association made changes to their manual DSM (5th), where they eliminated the Rett Syndrome as part of Autism category since it was a Genetic Disorder and then took the rest of the subcategories in the Pervasive Development Disorders (PDD) that were in DSM4 and place them as part of the Autism Spectrum Disorder eliminating the names given in DSM4, but keeping the characteristics found in them and place them under the new name of Autism Spectrum Disorder (ASD).
Since 2013, when an evaluation is done and a diagnosis is given under the DSM5, regardless of the cognitive, social and communication skill level the individual may have, as long as they fall within the spectrum the individual will be diagnosed with Autism Spectrum Disorder (ASD). Even if under DSM4 it would have been identified as Asperger’s Syndrome, or Autistic Disorder (autism), Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) also known as atypical Autism, Childhood Disintegrative Disorder, etc. these are all now part of the Autism Spectrum Disorder in the DSM5. However, the new evaluation allows the professional evaluator to specify the level of severity for each case.
Even though many may find these changes from DSM 4 to DMS 5 confusing, these changes were put in place to emphasize Autism is a Spectrum where each individual is unique in their strengths and challenges.
In the current version of ICD-10, Autism is classified under the Code F84 Pervasive developmental disorders
- 2 Rett’s syndrome
- 3 Other childhood disintegrative disorder
- 5 Asperger’s syndrome
- 8 Other pervasive developmental disorders
- 9 Pervasive developmental disorder, unspecified
It is important to mention that on June 18th 2018, the World Health Organization released the new International Classification of Diseases (ICD 11) and this will be presented at the World Health Assembly in May 2019 for adoption by Member States, and will come into effect on 1 January 2022. As far as the Autism Spectrum Disorder, it will have a new code 6A02 in the ICD-11 instead of the F84 in ICD-10. The ICD-11 shows ASD with its sub-classifications with and without disorder of intellectual development, as well as indicating the level of functional language. These new codes are more aligned with the DSM 5 manual.
- 0Autism spectrum disorder without disorder of intellectual development and with mild or no impairment of functional language
- 1Autism spectrum disorder with disorder of intellectual development and with mild or no impairment of functional language
- 2Autism spectrum disorder without disorder of intellectual development and with impaired functional language
- 3Autism spectrum disorder with disorder of intellectual development and with impaired functional language
- 4Autism spectrum disorder without disorder of intellectual development and with absence of functional language
- 5Autism spectrum disorder with disorder of intellectual development and with absence of functional language
- YOther specified autism spectrum disorder
- ZAutism spectrum disorder, unspecified
Even though it is important to have at least a general knowledge of how professionals go about giving the Diagnosis of ASD, it is even more important to recognize that each case of ASD is unique and that even though there is no cure for Autism, is imperative to have an Early Intervention program that includes individualized therapy sessions and monitoring to check progress and adjust the program as needed in order to see the best results in the lives of the individual as they grow and integrate more into society. These type of therapies may include Applied Behavior Analysis (ABA), Floor Time therapy, Speech Therapy, Occupational Therapy (OT), Physical Therapy (PT), Music Therapy, Play Therapy or Counseling, etc. based on the needs of each individual.
As of now the theory that Autism was caused by environmental factors or vaccines has been debunked, there are however many studies going on about the possibility of genetic links to Autism, not necessarily that Autism is inherited, but it can be identified as part of a gene in the individual’s DNA, whether it is inherited or perhaps a mutation of a gene, these studies are still in process and under a lot of research, but have not been yet officially included in the DSM 5 or ICD10 or even ICD11. So as of now, Autism has only been identified as a neurological disorder, and it’s development hasn’t been pinpointed if it’s starts at gestation or pregnancy or during early childhood development. Surely we will learn more as more research studies share their findings.
Many in the Autism community are not keen in these research studies, mostly because the funds could be utilize to improve the resources and services they receive rather than finding a cure, however they as well as parents welcome the interest in learning more about Autism and it’s origin as long as it is used to changed who they are, but rather spread awareness and acceptance.
For now, the increasing rate of diagnosis are not due to an epidemic, but rather due to increase in Autism awareness campaigns we now have it makes people more proactive in seeking to have their children evaluated at an early age specially if they feel something is off in their children’s development, not to mention that as technology advances it allows for better data record gathering and statistics than prior years. The Center for Disease Control and Prevention (CDC) reports that 1 in 59 children have ASD. A more recent report from Health Resources and Services Administration (HRSA) found that about 1.5 million U.S. children — or 1 in 40 have receive the diagnosis. However the statistics compared to other countries are not as high, for instance Ecuador has only reported around 180 thousand cases while Costa Rica has reported over 60,000, Guatemala over 225,000, these numbers compared to their corresponding population represent a very small percentage against the reports from CDC and the HRSA which tells us that globally there is still a lot people without a diagnosis and in need of the proper therapy and support from family and society making Autism Awareness an important mission to continue.
References:
https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f437815624
https://www.cdc.gov/ncbddd/autism/data.html
https://elperiodico.com.gt/nacion/2017/04/09/el-pais-registra-mas-de-225-mil-casos-de-autismo/