Oh goodness LOL!  I know what happened but it's a long boring story so I'll save it.  Fixing now, thanks!

And yet--I'm not sure if there's much we can really do to affect this decision?  Let's keep a look out for how and if the committee intends to honor the item from the report: "feedback will be sought from professional and lay communities before the Workgroup finalizes their recommendations."

Here is some feedback to begin with.

I think the proposed language for the DSM V is flawed in several respects -- but repairable.

First: there need to be more than 2 diagnostic categories.  As one single example: atypical sensory processing is a *huge* omission.  It's literally the 8-ton elephant in the middle of the figurative cocktail party at which the diagnostic standards are being established.  If there is any single diagnostic feature present in one form or another ubiquitously across the spectrum, it is atypical sensory processing.

Second: one of the 2 diagnostic categories they *do* propose retaining is a *sequela*, not a primary symptom -- rigidity and repetitiveness of behavior, which is a defensive *response* to primary sensory, communication, and/or social distress.

Third: removing difficulties in communication as a diagnostic category makes no sense at all.  The nature of communication difficulty varies across different points of the spectrum, but one or another manifestation of difficulty communicating (with the nonautistic majority), whether it be basic formation of expressive speech, higher-order organization of expressive speech or written communication, or real-time processing bandwidth for receptive speech, is quite often present, and significant.

Fourth: the claims of stability of diagnosis based on severity of one or another of these diagnostic categories need further examination.  Many people on the spectrum make significant gains over the course of their developmental trajectory in the very categories in which they are initially categorized as significantly disabled.

Fifth: the elimination of shorthand terms to identify particular common configurations of initial symptomatology in the (hopefully, ultimately, more than just 2) diagnostic categories is not a good idea.  The common configurations are starting points for determining needs and priorities in education, accommodation, and support.  A child characteristic of what is now colloquially called "classic" or "Kanner" autism (even though Kanner's own patients by no means all fell into that category) is likely to have as a top-priority need the development of alternative means of expressive communication, in lieu of expressive speech (or in parallel with efforts to help jump-start it), whereas a child characteristic of what the DSM IV calls "Asperger syndrome" is likely to have developed expressive speech and thus not have that need.  It must be understood that as development progresses the needs of these common categories will overlap and in some cases converge, but they start out at points different enough to shape the priorities of need differently at the outset.  I think the existing "shorthand" labels should be retained and in fact expanded upon -- and then used with care -- so that configurations of *priority* and *need* for particular supports and accommodations can most easily be recognized and met by the non-research stakeholders in the DSM: educators, clinicians, allied health providers, insurers, and most importantly, individuals on the spectrum themselves and their families and supporters.

Phil I think you have missed the point somewhat.

The Triad is dead, for how long now have we been saying that lack of imagination is not a symptom of anything but inability of the psychiatrist/clinician to have any when dealing with autism.

language and communication are intimately connected, if one considers what language is, (which is more than verbal)

Yep sensory needs to be dealt with, but really were we expecting Rocket science from DSM?

It is a book and researchers will continue in there own way despite of it anyway..

I would be interested to know what is happening on other fronts than the autism front, but I suspect that the book is just going throug a periodic re-alignment with practice rather than any radical new redefinition of anything.

re the maths to describe the space within spaces, you could try The Laws of Form by George Spencer Brown.  I got a real logician person to check it out, and he says its arguments are logically sound.  It's short, elegant and incisive.  I've no idea whether I understood it really, but I seemed to at the time.

I have tracked down a copy, written in 1967 and published in 69 very much a piece of it's time with references to the I Ching and RD Laing :)

Not really what I was looking for though, it seems to be more about establishing mathematical expressions from first principles and although the author thinks he is being clear and explaining everything to the novice, he really is not, and assumes more background than he ought.

I think I shall just have to invent a way of expressing points, vectors and volumes in n dimensional segments of infinate dimensioned space, and hope it will do. I suppose that is what everyone else does, and if it passes muster, that's fine, if it doesn't then I shall just have to be content with my ranking among the pseudoscientists :)

The logic seemed fine, essentially he was saying "I can use *my* language to establish any kind of expression that will hold true in that particular world I have called into being, (having defined in the process what *he* means by call.

Philosophically and imaginatively it won't stand up, in that as a creature of his time he is not aware of how his neurology and our evolution bounds what he can express through that kind of symbolic logic, and his worst fault is assuming the particular world he conjures is capable of expressing all possible worlds, when in my conception of reality, all he is explaining is that he can express a limited way of describing all possible worlds that is not bounded in any platonic external, universal, meta-universal, and multi-universal reality at all because he simply lacks the equipment to envisage that any bendy or flexible alternative set of rules might not exist if the *rules* of physics, and human consciousness were alternately configured. Now that is something I can imagine, but of course I cannot prove it, except by using language to distort logic, because the system of language, being what it is, and how it works, can do that. I guess however even Charles Dodgson knew that.

Or of course I could just plain admit that this bear of little brain found even that *simple* book too much for him and needs to go back to relearning a little old fashioned algebra and set theory and building from there. It really was more than thirty years ago that I gave up on it all, and my brain has probably got considerably more rusty in the interim.

I think it'll make it worse for obtaining services.  Because even most adults I know with what'd be classed as so-called "mild" autism need extensive services compared to the services non-autistic people need.  But people would see the word "mild" and assume there's not a problem there, just like they so often currently see the person speaking to them out loud and deny them services on that basis alone.

Indeed if one is taking a funtional model of severity then this is surely it, and is somewhat behavioral in its outlook allowing the notions of severity to be totally socially constructed by those who are least qualified to do so.

It's the perfect example of trying to make a medical model out of something that won't comply in an orderly way to that episteme.

I personally think they want to get shot of a lot of awkward people, whom they will accept (because you can't turn the research clock back) as autistic in one way or another, but not accept as people whom society has disadvantaged in an increasingly communication oriented economy.

It is going to end up as another meaningless compromise to be argued over for the next decade, whilst they hope for "holy grail" of biological markers to materialise, (which they will not in any form that they currently imagine they will, that I can guarantee )

Good catch, Amanda, something I omitted in what I wrote: the issue of *variability* of abilities over time and social context.  The "mild", "moderate", "severe" stuff in the proposed diagnostic descriptions completely fails to take that into account.