ICD-11 or DSM-5 for ASD?

It began in a North Carolina Lab, only to be transfered to Wuhan by Dr Fauci.

Martin said:

I read that there is a great deal of belief in medical circles that the DSM is of greater scope, more detailed and 'more accurate', than ICD. If this is so, and I cannot judge this as I am not a clinician, then the retention of DSM for mental health diagnosis would seem to be preferable.

There is much truth to what you say.about DSM being more detailed than ICD. However, one cannot deny that it is a publication designed first and foremost for the US with its culture and social expectations, along with the peculiarities of the privatised American healthcare system.

One reason why in the US ICD is used for medicine and DSM is used for psychiatric and mental health conditions is the fragmented system of healthcare where providers of medical services and mental health services operate in parallel, compared to Britain with its NHS and the way many services are accessed through a GP.

Peter mentioned the possibility of writing better diagnostic manuals for British people. It's certainly a possibility that should be looked into. Whether the NAS would be interested in such a project is a different matter. Do they do any R&D?

The example of my experiences - I worked for a university, I was merely WHO funded - was proffered as an example of the dysfunctionality of the organisation. An organisation that is dysfunctional in one regard may be so in others. It is a logical extrapolation.

I read that there is a great deal of belief in medical circles that the DSM is of greater scope, more detailed and 'more accurate', than ICD. If this is so, and I cannot judge this as I am not a clinician, then the retention of DSM for mental health diagnosis would seem to be preferable.

As you have engaged very fully in discussion about Asperger in this thread, and I was not the first to bring Asperger into the discussion, this is pretty rich.

The concept of a spectrum is more useful than the implementation of some relatively arbitrarily defined diagnostic 'boxes', in which to stick people, and out of which they are unlikely to move.

The concept of a spectrum encourages the assessment of each autistic person as an individual, and the subsequent provision of individually tailored support.

The 'box concept' encourages the partition of autistic people into separate cohorts and the provision of generic support for the people in each cohort. This, I believe to be divisive of the autistic community and fundamentally prejudicial to individualised support, which I think is self-evidently superior to its generic alternative.

In regard to 'the teacher', it was not obvious to me from the way you worded your post. It is really the recipient of a piece of information that decides if it is unambiguous or not, not the originator. A little like politicians, who wrongly say, "I am clear ...". This is nonsensical, only other people can decide if they are being clear or not. What they mean to say is, "I am clear in my own mind ...", or, "I wish to be clear ...".

Matters relating to any dubious activities of Hans Asperger, or his political views and association, are completely off topic for this discussion. Please refer to the OP. It's a question whether Britain should adopt ICD-11 as the primary reference for psychiatric and mental health conditions (including ASD) or should Britain stick with DSM-5?

It's almost an “is the Pope a Catholic?” type question. Of course it is a real teacher.

A bad experience working for the WHO is unfortunately not a valid reason to reject their publications in favour of those from a competitor organisation.

Choosing DSM as a result of grievances with the WHO then trying to ignore the connection between ICD and DSM, and how ICD is the keeper of the codes, is yet another case of brushing the dirt under the carpet.

The NHS is going to adopt ICD-11 for medical conditions no matter what folk think of the WHO. The question is whether the NHS will adopt ICD-11 for psychiatric and mental health conditions.

WHO paid my salary for a year. They were so bureaucratic, greedy for meaningless updates and inflexible that we never considered applying for funds from them again.

A - The man colluded in the murder of some of his patients, passive collusion, but collusion nonetheless. He fully deserves any ad hominem attack he gets, from any quarter.

B - My intellect is fully functional. I have no personal animus against Hans Asperger, how could I? I never met the man.

C - Just answer a simple question.

I do wonder whether it's really possible to have an intelligent discussion about this subject with somebody who launches an ad hominen attack on Hans Asperger. It certainly comes across to me that you have serious grudges and grievances towards the man to the point that emotion has overridden intellect.

If you sit down and have a good think about it, then you should be able to answer your own question whether it is a hypothetical teacher or a real teacher.

I have many issues with the WHO, but as I have previously stated: ICD is the keeper of the codes for DSM. ICD can survive without DSM but DSM can't survive without ICD until a version of DSM-6 is released that is completely freestanding and divorced from ICD.

It was at pains to explain this to an Evangelical Christian nutter (who was probably a member of Sid Cordle's fanclub) with a grievance against the WHO, but was totally unaware of the connection between DSM and ICD when they defended the use of DSM for psychiatric and mental health conditions.

The ICD-11 is issued by the WHO. That's reason enough for me not to want to adopt it in the UK. The WHO has lost all credibility due to its complicity with allowing China to cover up both the Coronavirus lab leak and the secret Biological weapons research conducted at the Wuhan facility by the Chinese government.

Is this a hypothetical teacher, created for argument's sake?

A primary school teacher thinks that lumping all the different types of ASD under a single banner is a mistake. The spectrum is so huge that a person with no noticeable speech and language delay and average or above average academically in the main subjects cannot be compared with someone who is almost completely non-verbal or someone who is very behind academically and spends half the day sitting underneath a table growling like a wolf and the other half throwing objects around the classroom. The teacher has seen them all and thinks that there are reasonably clear subcategories for ASD and this helps to understand why it is so different for people. Each of the three aforementioned people require very different types of support services in a school setting.

Another term that the teacher really hates is BAME because it lumps together a diverse and disparate collection of people into something that is treated as if it were a single homogeneous group.

The difference is in using a hard or soft 'g'. The hard 'g' sound is the original German pronunciation. I identify as autistic, and I have outperformed the majority of neurotypicals academically. However, I do not wish to abandon or disown my fellow autistics who have less ability than me. I think the concept of Asperger's Syndrome is deeply unhelpful, as it creates an 'us and them' situation.

Martin said:

In addition, it sounds like 'ass-burger' or 'aarse-burger

I take objection to this I have always pronounced it as-sperg-ers. As far as I can tell ass-burgers is an American import pronunciation.

Martin said:

Bizarre response. You obviously have a lot of emotional investment in the concept of 'Asperger's Syndrome'.

Is that so difficult to understand? The average man in the street thinks autistic = rain man. It's worth reminding them that some of us equal or even out perform them in important areas of life. I'm not sure if keeping the term Asperger's is the way to do that but I'd think it'd be obvious why you might want to continue to emphasise that.

Martin said:

In the manner of Asperger, people use his eponymous syndrome to draw a distinction between themselves as autistic 'Übermensch', who are 'intelligent and functional', from the 'Untermensch' of non-verbal, and/or intellectually and/or cognitively challenged autistics, whose functionality in society appears to be less. I think the present use of 'Asperger's Syndrome' is open to this sort of unpleasant usage and it is for this reason, and not in order to re-write history, or invalidate any research, that I think that its contemporary usage should be abandoned.

It isn't anything to do with 'Übermensch' vs 'Untermensch'. It's just that the needs and requirements of people with AS and the people with traditional or Kanner autism are considerably different when it comes to the provision of support and services. A bit like the needs and requirements of blind people and people who use wheelchairs are different. Any primary school teacher will tell you this.

There is definitely anecdotal evidence that wherever DSM-5 ASD is adopted then people with an Asperger or an ASD Level 1 diagnosis are being pushed to the back of the queue and treated as lower priority when it comes to support and services on the basis that they are too able, with most of the resources channelled towards people on the more severe end of the spectrum.

Martin said:

In addition, it sounds like 'ass-burger' or 'aarse-burger and in any English-speaking country this ridiculous connotation is sufficient reason, in my view, for it to be dropped.

Very questionable and debatable.

There have been concerns raised over the perception of Asperger vs autism by employers, and whether a label of autism will harm employment prospects compared with Asperger.

Eugenics in liberal democracies did not, except in theoretical discussions - as far as I am aware, seriously advocate the mass murder of disabled people.

In reply to your last question, unlike Asperger, I am not a Nazi. I condemn book-burning and censorship. I have no problem at all with Asperger having existed, and having published studies. Equally, I have no problem with other people having used his name in their studies, in the past. What I am advocating, is that people in the present-day should stop using and identifying with an outdated nomenclature.

In the manner of Asperger, people use his eponymous syndrome to draw a distinction between themselves as autistic 'Übermensch', who are 'intelligent and functional', from the 'Untermensch' of non-verbal, and/or intellectually and/or cognitively challenged autistics, whose functionality in society appears to be less. I think the present use of 'Asperger's Syndrome' is open to this sort of unpleasant usage and it is for this reason, and not in order to re-write history, or invalidate any research, that I think that its contemporary usage should be abandoned.

In addition, it sounds like 'ass-burger' or 'aarse-burger and in any English-speaking country this ridiculous connotation is sufficient reason, in my view, for it to be dropped.

Martin said:

Hans Asperger deserves to be attacked. He extolled 'high functioning' autistics as useful to the Third Reich for their possible technical skills, while consigning those autistics in his care who showed less obvious usefulness, to the tender care of Nazi eugenics (i.e. to be murdered). If this is not execrable in a human being, and even more so in a clinician, I do not know what is

Eugenics was practiced in both the US and Britain before and after WW2 by clinicians, so it would by hypocrisy to attack Hans Asperger on this point.

Martin said:

Relegating Asperger and his syndrome to history does not invalidate those of his findings that remain useful, no more than it does the same to the work of any subsequent clinicians or researchers. It merely means that the term 'Aspergers Syndrome' is replaced with 'autism'.

In a similar way that you cannot have Christianity without Jesus, you cannot have Asperger Syndrome – no matter what it is called – without Hans Asperger. To call it autism for the simple reason that Hans Asperger does not deserve to be honoured is nothing short of brushing the dirt under the carpet, and is unacceptable behaviour from a scientific perspective. If ASD is to incorporate the findings of Hans Asperger then it has to cite and reference his research.

Are you trying to imply that books written about Asperger Syndrome should all be burnt?

Bizarre response. You obviously have a lot of emotional investment in the concept of 'Asperger's Syndrome'. Hans Asperger deserves to be attacked. He extolled 'high functioning' autistics as useful to the Third Reich for their possible technical skills, while consigning those autistics in his care who showed less obvious usefulness, to the tender care of Nazi eugenics (i.e. to be murdered). If this is not execrable in a human being, and even more so in a clinician, I do not know what is

Relegating Asperger and his syndrome to history does not invalidate those of his findings that remain useful, no more than it does the same to the work of any subsequent clinicians or researchers. It merely means that the term 'Aspergers Syndrome' is replaced with 'autism'.

Martin said:

Aperger and his syndrome need to be consigned to the dustbin of history, if only because Asperger was a marginally less depraved Nazi than Josef Mengele. 

This is an ad hominen attack on Hans Asperger.

It's unacceptable (and highly unscientific) to discredit or attempt to obliterate the research findings in a field of medicine because of an individuals dubious activities and lifestyle, or their political views and association.

Obliterating the research findings of Hans Asperger will also systematically obliterate the subsequent work on the subject by Lorna Wing, Uta Frith, Tony Attwood, and even Luke Jackson, amongst others.