autism spectrum disorders and dsm-v politics

An article in the New York Times this morning by Simon Baron-Cohen addressed the debate in the DSM committee over subsuming the conditions of Autism and Aspergers in the fifth edition of the "psychiatric bible"(promised in 2012).  The committee is deliberating whether or not to eliminate Asperger from the diagnostic manual and characterize its discrete symptoms as a degree of autism in the spectrum (perhaps "intermediate functioning autism").

Autism and Asperger syndrome are both characterized by impaired communication skills, a desire for keenly focused stimuli and strong inclination toward repetition. They are distinguished only by a slower onset of language skills and latency of intelligence in autism, says Baron-Cohen.  He further suggests that this distinction is proving not to be concrete enough, and that the DSM-V committee's struggle with the controversy can be attributed to the lack of physiological distinction of these psychiatric conditions.

I would agree with Baron-Cohen that there is not currently enough genetic distinction between autism and Asperger syndrome to warrant their being entirely separate conditions outside the spectrum disorders umbrella in the DSM-V.  However, I think that defining Asperger syndrome idiosyncratically is important to preserve in the new manual.  Here is why:   

1)  Baron-Cohen mentions his own group's recent identification of 14 Asperger-specific genes,19 genes specific to autism and 7 shared (Chakrabarti et al 2009).  They measured 68 candidate genes in two experiments: the first measured autistic traits in an undiagnosed sample population using the Autism Spectrum Quotient; the second, using the Empathy Quotient.  These two experiments were designed to identify autistic and Asperger cases among the sample:

"We searched for common genetic variants (single nucleotide polymorphisms (SNPs)) on the assumption that autistic traits are continuously distributed in the general population [Constantino & Todd, 2005; Sung et al., 2005]."

"In Experiment 1, autistic traits (measured on AQ and/or EQ) were nominally associated at P<0.05 with SNPs from 19 genes. In Experiment 2, SNPs from 14 genes were nominally associated at P<0.05 with AS."

Six genes were nominally significant in both experiments. This study alone suggests that Asperger syndrome deserves a distinction as a sub-group in the Autism Spectrum Disorders (ASD) category that the DSM-V committee is considering, as opposed to eliminating it entirely, as is also being considered.

The Charkrabarti study is impressive, and the first step in the important attempt to identify the genetic and epigenetic correlates of autism and Asperger separately.  However, there is still an extensive amount of correlative research to be done.  A good amount of this is ongoing through the AutDB Project.

2)  If for no other reason than to preserve the honor of the venerable Hans Asperger.

3)  To keep company the solitary other recognized ASD, Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS).*  Perhaps these could both become sub-groups in the ASD category.

It is noteworthy that a great deal of genetic research already refer to their studies as ASD interactions/links/correlations (PubMed or Google Scholar this).  I am terribly eager to find out whether or not this plays a strong role in the decision of the DSM-V committee.


*High- and Low-functioning autism are not classified as spectrum disorder subgroups, although they should be... and perhaps, one day, will be, provided there is a physiological distinction to be drawn between them, Asperger and PDD-NOS.

piaget + bohm

When we are infantile, we perceive the world in terms of transformations and continuity. When someone's head disappears behind the playpen wall, it no longer exists. And when someone's arms extend from behind a tree trunk, they are part of that tree trunk. And when that tree appears fairy-sized beside our hand, it is not because the tree is far away, but because you have discovered its untouchable miniature right in our presence. A thing happens to us between this time and adulthood that morphs that cononical perception into an interspersed mass of objects and interactions. Language.

Particularly Indo-European languages (English, French, German, etc.) are primarily based on nouns. We think, communicate and perceive based on what language has done to our interaction with the world. We fragment its natural cohesion just by the way we behold it.

Language was once verb-based... transformation-based. Native American languages, Bengali and other endangered linguistics. These were also peoples who interacted with reality as if it were all actualized in the same condition, and from the same piece of cloth and ultimately still cohesive.

empty thoughts V

as i sit here in class wishing that Miller would become as awesome a professor as he is a person, but accepting that, tragically, this will never be...

5. Oh Steven Pinker, how I treasure you...

Pinker thinks grammar development is a support for non-selectionist theories of language development. He says that grammar is more complicated than it need be for the purposes of hunter gatherer lifestyle, with which I agree. However, I also think that when grammar/language was in initial stages of evolutionary development, it was probably exactly as complicated as it need be for that purpose. I like to think of the late H. s. sapiens as still being hunter-gatherers, and that as our hunting skills evolved to become more complicated, so did our language. This being said, I don’t think that the present complexity of language is an argument against the contribution of natural selection to language development. It’s just as conceivable an idea to me that just as our hunting skills suffer from a severe deficit inflicted by our obsession with making our lives easier and our physical selves more lazy, so has language diverged from being purely a survival tool into… well, Sheharazade on steroids. Then again, some of us have become so exotically lackadaisical with language that it's also become somewhat useless as a tool of any sort.