Autism services should be based on need, not diagnosis

An expert panel appointed by the American Psychiatric Association is completing work on the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and the proposed change in the autism diagnostic criteria has been getting a lot of attention. The New York Times discussed the potential effect of the upcoming change, MSNBC produced a piece about it, and Nancy Snyderman, one of my favorite medical media professionals, discussed this issue on the Today Show recently. Clearly this is a big deal in the autism community.

The big deal to those of us at Easter Seals is that individuals with autism receive the supports and services they need to lead a high quality life. In all the media hullabaloo, the discussion about the diagnostic changes are paired with the message that these changes could/would limit access to services. I may be a dreamer, but wouldn’t it be great if individuals received services based upon need instead of a diagnosis?

Even with the current diagnostic labeling strategy, we hear too many reports of individuals with autism not being able to access services — an individual with Asperger Syndrome who didn’t qualify for services as their IQ score is too high … individuals with autism who perform too independently on activities of daily living to qualify for services … that sort of thing. These are people who are not able to find work or engage in education or make friends or find housing because of the nature of their disability — but still, they don’t qualify for services early on?

So, I agree that policies that decrease access to needed services do not assist individuals with autism to become contributing members of our society. But there is a bigger question to be asked than why these changes are being proposed to the diagnostic criteria. The bigger question is this: why hasn’t our society made the decision to support the members of our community who need assistance?


 

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