Last week after writing about the DSM-V “Temper Dysregulation Disorder with Dysphoria,” I received several emails asking my opinion regarding the proposed merger of autism and Asperger’s disorder into a single ’spectrum’ category.  This change has clearly generated some significant political debate in the media and the blogosphere, with some in favor of the change (see for example Dr. Roy Ginker’s NYT article), while others have expressed reservations about the potential impact that this change may have in the autism and Asperger’s community. So I wanted to keep my contribution to this discussion somewhat removed from the political/social issues associated with the change, and instead focus on the scientific/clinical basis for this specific move.  Thus, my aim with this post is not to take a position for or against the proposed DSM-V changes. Instead, I simply want to provide some background information about some of the research data and clinical issues that may have contributed to the DSM-V committee’s decision to propose the merger of all ASDs into a single category. Read More

FOCUS ON AUTISM WEDNESDAY:

When conducting assessments with individuals with autism or other developmental disorders clinicians are often interested in examining the person’s  “adaptive functioning” or how the person actually functions in every day life, usually in specific domains such as communication, sociability, motor functioning, and daily living skills. Clinicians and researchers are also interested in exploring the factors that predict adaptive functioning. One obvious candidate factor is cognitive capacity, or IQ.  It is expected that the more cognitive skills you have, the better you would do in daily living demands. However, researchers have shown that for individuals with high functioning autism, cognitive functioning is not always correlated with adaptive functioning. That is, some individuals may present cognitive skills that are within normal levels, yet display impaired adaptive functioning. Yet, less is known about the relationship between cognitive functioning and adaptive skills among children with more severe autism. For example, do children with low cognitive skills present even lower adaptive functioning or do these kids show higher adaptive functioning than expected based on their cognitive skills? Knowing this information could have implications for treatment, especially for the manner we use cognitive skills as a proxy for prognosis and to guide expectations. Read More