Please note, some of our older posts like this one may not reflect the latest terminology and diagnostic guidelines – click here to read them in our blog on autism diagnostic criteria!
“Autism may be the most confusingly diagnosed and labelled condition across the entire world…”
Whilst we aim to be positive here at Spectra.blog, there’s so much that’s frustrating about the state of autism diagnosis, currently! (At the time of writing in June 2018). Or rather, there are inconsistencies and misunderstandings, as well as disparities, in terms of different clinicians, authorities, countries and territories, and their protocols. It’s no wonder that people new to the world of autism information are left feeling confused.
ICD-10 / 11 – UK
For example – a national (UK) training body offering a nationally-recognised autism qualification confidently (and incorrectly) maintains (at the time of writing in June 2018) that the three main autism diagnoses are ‘severe’, ‘high functioning,’ and ‘Asperger’s Syndrome’. These autism ‘functioning labels’ are in fact no longer used.
Meanwhile, up until summer 2018, the 2016 version of the ICD-10, (ICD being short for: ‘International Statistical Classification of Diseases and Health Related Problems’, the most commonly-used diagnostic manual in the UK), listed Childhood Autism, Autistic Disorder, Atypical Autism, Asperger Syndrome, as well as the clumsy ‘Pervasive developmental disorder, not otherwise specified’, as the main autistic categories.
(NOW, with the launch of the latest ICD-11 in summer 2018, only ‘Autism Spectrum Disorder‘ is stated, with varying sub-descriptions – see graphic.)
Meanwhile in America, within the DSM5 diagnostic manual, clinicians are advised to also use the broad term Autism Spectrum Disorder, but with a numerical note of severity, and / or the additions of ‘With or without accompanying intellectual / language impairment,’ dividing the ‘severities’ from 3 to 1. (e.g ‘Autism Spectrum Disorder level 1’ is seemingly akin to an Asperger’s-type diagnosis, under the ‘older’ system).
To further confuse things, for individuals diagnosed BEFORE the functioing labels were abandoned, there’s seemingly very little diagnostic difference between High Functioning Autism (HFA) and Asperger Syndrome. The differentiating factor was whether or not developmental and language delays were seen in infancy, but in all honestly, that’s surely often subjective, based on familial memories?
In any case, someone diagnosed with the (now outdated) ‘HFA’ doesn’t necessarily accept that they are similar in diagnosis to Asperger’s, and vice versa, perhaps due to how the diagnosing clinician or explained made their diagnosis.
Another confusing element is the continued use in conversation of the OLD functioning labels, (mild, severe, high functioning, low functioning), which DSM-5 and ICD-11-using clinicians now omit, but that many people still use conversationally (as do, as discussed, some training providers of autism courses / qualifications).
Furthermore – what about the situation we alluded to at the start – that many people aren’t happy with the reference to ‘disorder’, preferring ‘condition’ or neurology? A great, valid point, but it is important to provide information online for anyone searching for clinical resources.
All in all, it is an extremely confusing situation – but perhaps with the UK’s recent publishing of the current version of ICD-11, everything will become clearer?
A little disclaimer – here at Spectra.blog we don’t claim to be experts about Autism; the information we post here is based purely on our own exposure and experiences.
If you fancy some more ‘ranty content, you may also like –
‘Is Autism’s Triad Of Impairments outdated? (ASC / ASD / Asperger’s) – and ‘Them V Us – disparity in the autism spectrum condition ranks (ASD/ASC/Asperger’s).’
Also published on Medium.