By Shell Tzorfas-
All three arenas are having their names and categories altered, two of them for the purpose of streamlining their definition in the DSM5. In the DSM5 (Diagnostic and Statistical Manual of Mental Disorders), put out by the American Psychiatric Association, the definition of what constitutes autism is about to be changed. Whole categories are to be removed by the psychiatric association. Terms such as Asperger's Syndrome and the PDDNOS (Pervasive Developmental Disabilities Not Otherwise Specified) are being removed from the DSM5; and they are coming under the axe in order to create supposedly less confusion. Many of us are aware that in essence, by un-diagnosing these kids, it may reduce services in education, health, and other opportunities. Simultaneously, the same thing seems to be going on in the music industry.
The NARAS; National Academy of Recording Arts and Sciences, is attempting to drop 31 categories of music. The NARAS defended its actions by claiming that many categories were old and no longer represented a modern view of the music industry. According to Oscar Hernandez, a Grammy-winning member of the NARAS, this decision endangered many in the music industry.
Alzheimer's and autism are about to face the same fate; their lifespan is going to be shortened and streamlined just like the music industry. The definition for both is about to go into analysis and under the knife. Asperger's in plain English was the high functioning autism that the term "Rocket Scientists" would bring to mind. Geeks and nerds from the past may have fallen into that category. Think Dr. Sheldon Cooper, who plays the role of theoretical physicist focusing on quantum mechanics and string theory on the show, "The Big Bang Theory." The character Dr. Sheldon Cooper is obsessed with his field, but must eat a certain food and visit the comic stores on Wednesday nights. Changing the schedule would put him into a panic. He lives by structure and he can not handle disruptions. He is unable to make transitions from one activity to another and is anal retentive about his likes and dislikes. And watch out if you sit on HIS spot on the couch.
The criteria for "Alzheimer's is about to be changed as well." Most people currently diagnosed with a mild form of Alzheimer's disease are about to be downgraded away from this term and re-categorized as having MCI - Mild Cognitive Impairment. This is according to an article authored by Rachel Rettner found inLiveScience.com on February 6, 2012. The article goes on to say that people diagnosed as having 'Mild Alzheimer's disease' would be reclassified as having Mild Cognitive Impairment. MCI is recognized as an intermittent stage between "normal" loss of cognitive function that comes with age, and the development of Dementia. In essence they are changing and expanding the definition of Cognitive Impairment. It is a decline in cognitive functioning due to loss in memory and language, but does not interfere with everyday activities, yet reduces the Alzheimer's population.
According to the National Institute on Aging and the Alzheimer's Association, people with MCI can function independently. This could mean that even if people have some difficulties shopping, paying bills, and cooking but could still function, they would now be diagnosed as having MCI. Dr. John Morris, a professor of Neurology at Washington University School of Medicine, looked at people in a study and found that approximately 92% to 98% could be reassessed as having MCI and not Alzheimer's based on some tasks they were asked to perform including cooking and taking medication. This means that possibly 2 million people would have the diagnosis changed.
William Thies - chief medical and scientific officer of the Alzheimer's Association - says the proposed changes to MCI are only around a year old and that Alzheimer's is a "...Continuum. We are trying to identify exactly where people will fit in the continuum of Alzheimer's." Where have we heard this before? It is nearly the same conversation that we are hearing regarding changing the definition of autism for the new DSM5. Autism Spectrum Disorders are also known as a continuum. The DSM5 proposes to streamline the definition to help clear things up and avoid confusion without taking responsibility for how that will affect numerous children across the country, not to mention other countries as well. Many schools for example already push parents to get a medical diagnosis in order to give their children more academic assistance. Special help for children struggling in academic areas was not designed to depend on a medical diagnosis, but in reality, schools have managed to make it appear this way to parents. Just like the proposed changes to the MCI are about a year old, so are the proposed changes to the DSM5.
Additionally, the proposed changes by the NARAS to remove categories in music are taking place as well. It seems that there is a far bigger picture here than what meets the eye. These three organizations are opting to streamline different definitions and different categories supposedly in an effort to benefit people. The truth is that it will eliminate help for many people, but line the pockets of the organizations. Take for example the people writing for the DSM5. When Asperger's and PDD is removed, schools will probably seek a "re-diagnosis" so that special education services could be restructured. Like everything else, the school budget is at risk and schools can no longer afford to have an abundance of services for the now 1 out of every 6 Developmentally Disabled kids or 1 out of 5 Neurologically Impaired kids. By changing the diagnostic criteria for autism, suddenly "POOF," large numbers of autistic children will magically disappear. Years and years of "better diagnosis" will bleed into un-diagnosis.
The revision that all 3 of these organizations are attempting to make is about money, period. Alzheimer's patients being redefined as having Mild Cognitive Impairment, will probably no longer be eligible for the supervision of nurses or other insurance benefits. Many musicians will not be able to partake in the financial benefits of earning a Grammy Award particularly those in Jazz, Latin, and Hawaiian categories. Kids with PDDNOS will no longer meet the criteria necessary for health insurance or school to implement occupational, speech, or physical therapy. We have been seeing this pattern emerge in the health industry, but it has been occurring quietly in many aspects of life. Towns have been merging in order to share services and thereby save money. We have seen towns sharing police and fire departments, as well as administrative offices. We have been seeing different schools sharing child study teams. These shared services have not improved the quality of life. The benefits of saving money have not trickled-down to the individual.
This says that it is hard to tell the difference between MCI and early Alzheimer's. This is a dangerous slope in my opinion. Take for example the MCI guy who decides to make a breakfast consisting of eggs and a pot of tea. He turns on the stove and begins to cook. It is Sunday morning and he remembers that the NY Times was delivered to his front porch. He goes outside in pajamas and slippers, and forgets to take the key. Now, with the eggs cooking on the burner and the water boiling while the man is stuck outside, there is potential for the house to be in danger. At this very moment, it is Alzheimer's. MCI is the diagnosis, but the outcome of the forgetfulness sure has similar effects as Alzheimer's. By calling this MCI, he would not be eligible for certain assistance that a person with Alzheimer's could get such as part-time nurses to watch over him or certain therapies.
It appears that all this fancy footwork amounts to nothing more than a mere name game change. Changes are not always beneficial and children with autism will not go away. After all, a rose by any other name is still a rose.
Shelley Tzorfas has been working with Autistic, ADHD, and Dyslexic children for more than 20 years. She has a Master's in Fine Art from Rutgers University. Shelley is convinced that most of these illnesses are based on concrete, physical issues that can be corrected - not mental or psychiatric. She believes that she was able to recover so many of her individual clients because of having dyslexia herself. Her upcoming book "Recovering Autism, ADHD, and Special Needs" pulls together all the different resources for the purpose of helping YOU to recover YOUR child. Feel free to google the book title to see the video on YouTube.