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The Big Unknown: The projected effects of DSM-5

Jan 26

by David Dobkin on 26 January 2012 in , with 0 Comments

Autism, is again on the front pages of our media.  There have been a lot of opinions and emotion being spent on the proposed changes to the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, with regard to an autism diagnosis.  Rather than just debate the merits or lack thereof of the proposed changes, it is imperative to ask the questions, why does the diagnosis need to be changed?  Who benefits from the change and who loses? In the end, it comes down to money.  Changing the terminology of what counts as Autism and what gets a shiny new word is irrelevant.  Our children will not magically get better with a new diagnosis.

 

So why do we need to change the diagnosis? Well, as the New York Times so eloquently put it, "Proposed changes in the definition of autism would sharply reduce the skyrocketing rate at which the disorder is diagnosed and might make it harder for many people who would no longer meet the criteria to get health, educational and social services".  All this may amount to is cost savings for insurance companies and our already bankrupt local governments.  The operative word being may.  The scariest thing about this proposed change is that it is a change that in all likelihood will take away services and cost families money. 

 

The sad part about this goes beyond the human hurt that all of us living everyday with someone who has a diagnosis, is the malice and blatant disregard to actual issue that autism rates are rising, no matter what we decide to call it.  You can use the new definition, or the old definition, but at the end of the day, we are still left with the same amount of sick children.  This is something the entire autism community can agree on. 

 

Rather than addressing the issues of treatment, stemming the epidemic, and researching why the diagnosis is 1 in 110 and 1 in 6 with learning disabilities, our healthcare professionals are looking at ways to reclassify the argument, which is just an exercise in semantics.  If they really wanted to treat the problem, one would think we would get significantly more diagnoses, each with a better defined treatment schedule.  But in order to do that, the psychiatrists would first need to sit down with primary care physicians and realize that there are other issues and symptoms common in people with ASDs.  Gut issues, skin issues, there area whole host of things that can be said are wrong with our children in addition to their mental health shortcomings.  If we take a more holistic approach to diagnosis, and pour our efforts at identifying multiple cases, instead of using a catch-all term, we would find that there are a whole host of maladies that can be treated. 

 

Amazingly, this would actually be cheaper for insurance companies and our social services because we could stop throwing the entire kitchen sink at our kids in search of health.  Imagine being able to provide selective treatment services based on a child's actual need. 

 

It is absolutely shocking that the healthcare establishment cannot make this connection.  Even 16 year-olds know that what we put in our bodies has an effect on our minds.  Anyone have a beer lately?  Sadly, the new DSM will only cover mental health and behavioral issues that will fail to acknowledge the body as a whole, missing out on a golden opportunity to better diagnose the rainbow of ASDs.

 

All these changes will do is reframe the argument.  I challenge the mental health professionals who feel the need to play in semantics to use either definition and and look at the adult population for any correlation.  I am sure they will still find rising rates.

 

The autism epidemic in the US is a highly personal and simultaneously polarizing issue that continues to stir debate as well as considerable angst and a financial burden for families with living with a diagnosis.  Its time we stop with semantic arguments and reframing the problem and start using our resources to find a solution. 

 

*Iain McDonald, David Dobkin and Bodhi Dobkin - Family Photo in New Zealand

 

 

 

 

 

 

 

 

About the Author:
David Dobkin is currently the Investment Manager at New Zealand Trade and Enterprise overseeing the foreign direct investment from the United States into New Zealand in the healthcare and manufacturing sectors. Prior to his time with the New Zealand government David worked for Lazard Freres one of the world’s preeminent financial advisory and asset management firms where he facilitated and advised on cross-border mergers and acquisitions transactions in excess of $3 billion for Nike, Lockhead Martin, Quiksilver, Wynn Resorts and others. Prior to working in the financial industry David was one of the lead researchers in heart valve, tissue engineering and stem cell research at Children’s Hospital Los Angeles.

David received a Masters of Science, Biomedical Engineering, from University of Southern California and a Bachelor of Science, Biomedical Engineering, from Columbia University.
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