One undercurrent in the debate has been the suspicion that the change was made to cut costs. Attwood and King both said that although that might or might not have been an intention, it will be an effect.
"The medical insurance companies and other agencies will save money," Attwood said. "I can't say that this has been the driving force of the change; all I know is that this is the highly probable outcome. With fewer people being diagnosed, it's going to be less expensive for the agencies that support such individuals -- either government or private."
Some people with Asperger's may fit under "social communication disorder" in the new DSM-5.
The manual also is adding "sensory sensitivity" to the autism spectrum criterion. This involves extreme sensitivity to a person's environment, including the touch of other people, the sensation of the clothing they wear, and sights, smells and sounds around them. Attwood praised this addition.
"The ultimate impact of the DSM is going to be wait-and-see," King said. "It's a guideline, not an absolute end-all and be-all of how to treat this. A clinician can use their own judgment based on their own experience."
The U.S. National Institute of Neurological Disorders and Stroke has more about Asperger's syndrome.
SOURCES: Catherine Lord, Ph.D., director, Center for Autism and the Developing Brain, New York-Presbyterian Hospital/Weill Cornell Medical College, New York City; Liane Holliday Willey, senior editor, Autism Spectrum Quarterly, and autism consultant, Grand Rapids, Mich.; Brian R. King, L.C.S.W., relationship coach, Illinois; Tony Attwood, adjunct professor, Minds & Hearts Clinic, Brisbane, Australia; Eric Lipshaw, college stu
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