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Roy Grinker on Proposed DSM V Changes to Asperger's

Kitchen sink By Anne Dachel

I just ran across a recent New York Times opinion piece about the changes being made in the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association.  The writer was long time autism denialist, Roy Grinker.  I say denialist because he denies there’s anything wrong with having hundreds of thousands of kids with autism. 

Grinker claims that there’s been no real increase in autism, or that vaccines are a factor, or even that we should worry about autism.   From the sound of his op ed article, we should just embrace autism. 
The main message from Grinker in the Times is that it’s a great idea to include Asperger’s Syndrome in the definition of autism in the official DSM.  According to Grinker, his daughter's experience with Asperger's has been rewarding.  He's happy about the one big autism family they're about to create.
“If this revision is adopted, the condition will be folded into the category of “autism spectrum disorder,” which will no longer contain any categories for distinct subtypes of autism like Asperger’s and 'pervasive developmental disorder not otherwise specified' (a category for children with some traits of autism but not enough to warrant a diagnosis).”
Grinker called the piece, Disorder out of Chaos, and he devoted most of the writing to telling us how all levels of autism are alike. 

He feels that since we’re now so accepting of autism, the stigma of an autism label is disappearing.  Therefore, we should just lump everyone together under the term “autistic.”  Grinker ends the piece quoting his daughter, ‘My name is Isabel and my strength is that I have autism.’  I had to wonder how many of the parents I know in the autism community could ever imagine that statement being made about their child.
I personally can't understand what motivates the APA in making this change.  If every child with autism were like my son John and Grinker’s daughter, both of whom have Asperger’s, autism wouldn’t be such a disaster for this country.  The truth is, classic autism is so devastating that parents don’t have the time to write opinion pieces.  Those parents don’t have children who can carry on conversations about having autism like Grinker’s daughter can.  Many autistic children I know don’t talk at all.  Some are still in diapers as teenagers.  They’re a danger to themselves and to others.  They’re in need of constant care and supervision.  Many of these children have severe health problems associated with their autism like seizures and bowel disease. 
I really fail to see how putting my son, who drives, has normal speech, and is great on the computer in one group called autism, will do anything to address the autism crisis in this country.  The medical community has no answers when it comes to autism. 
Millions of dollars are wasted in pointless studies while the cause, treatment, and cure remain unknown.  Does this DSM change do anything to stop the autism epidemic?   Will it provide any answers for parents?  Will a single child be helped?
What it may do is create enough confusion over the numbers so that no one will be able to tell if the rate is really going up or if it’s just because they’ve added Asperger’s to Autism Spectrum Disorder.  I can imagine the news reports when the next increase
in the autism rate is announced: “Officials aren’t sure if the new numbers mean that there are more children with autism or if it’s merely an expected result of including
Asperger’s in the diagnosis of autism.”
Maybe that’s what the APA had in mind in the first place.
Anne Dachel is Editor of Age of Autism.



To say that Asperger Syndrome does not belong with other Autism Spectrum Disorder simply proves a lack of knowledge about the disorder. Asperger's is a Pervasive Developmental Disorder, one that exhibits many of the same characteristics as Autism. Although it is on the high-functioning end of the autism spectrum, and has an onset at age 3 or later, it is still clearly a form of autism, however mild it may be.

Cherry Sperlin Misra

In my humble opinion, the rate of new cases of autism has been falling since about 2004. But our opposition cannot keep the doctors on their side if they cannot say, "We took out the mercury and autism is still rising" So by hook or by crook, the autism rate must actually rise or appear to rise. Adding Aspergers in with ASD should do the trick nicely. Other options? - delay giving out data about autism rates post 2003, or mix that data with pre 2004 data. Finally, if they can string it all out long enough, they will be able to blame mercury in the environment rather than mercury in vaccines. Someone will suddenly "discover" that fish is high in mercury and city water supplies are high in mercury.
I often wonder, Who are these faceless evil people who dont care at all that little babies in India can get 9 mercury laden vaccines by three and a half months of age ? It would all stop tomorrow if some of them would speak out


I said this on Katie's post yesterday - but here it goes again...

I'm even more terrified with the new DSM-IV criteria coming down the pike.

The "aspergers diagnosis is going to be removed!" brew-ha-ha is a smokescreen for the terrifying reality I now see before us:

The psychiatrists/psychologist really won't let go - the new DSM-IV won't say a word about autoimmune, mito, bowel, etc.



Anne thanks for your reply.

I am so sorry all they have offered your son are the two C's: cooking, and cleaning. Is there a third C? My son is also 23.

I can not even seem to be able to get my son SSI. I have been trying for three years now.

He would draw 5,000 dollars a year plus medicad. If I could get that money I would spend it on epilepsy medicine.

Could you write about some of these experiences that you have had????
That could help a lot of us; some of us right now, and for the others that are coming down the pipe line.


I have some theories about why lumping all the subcategories together serves industry, for which Grinker is a paid mouthpiece.

1) The DSM, more than anything else, is a psychopharmaceutical prescription code manual. Consider the fact that industry has lost billions and faced criminal charges for off-label marketing and that autism represents a growing "market niche" for drugging. So placing all related diagnoses under the same umbrella is a way to proactively simplify the approval process and close loopholes by which doctors who prescribe off label would be liable and makes drug injury suits more difficult for victims. If PDD-NOS was not, for instance, universally designated as "autism" in all cases, there would be wiggle room to hold drug companies and doctors responsible for marketing and prescribing to individuals with this not-quite-autistic condition if a drug was only approved for "autism".

Then, if a psychopharmaceutical is tested on one subtype of autism (for instance, a new antipsychotic or antidepressant for Asperger's)-- and if all forms of autism are lumped together-- the drug's approval can be extrapolated to all subtypes, broadening the market, and again reducing liability by closing "litigation wiggle room".

This is particularly tempting to do because, if Asperger's represents a "lighter" form of autism (i.e., less severe brain damage than "classic"), individuals with Asperger's might generally develop fewer immediate side effects or die less frequently in drug trials than those with more severe forms (whose brain damage might be more easily exacerbated by the drugs in other words), making Asperger's patients more convenient subjects for the drug approval process.

Also very importantly, the drug can then be mandated for all subtypes. Mandated and court-ordered drugging of individuals with autism is a "growth market" as the tsunami of children with autism reach adulthood and sometimes end up in institutional and residential care. This is because their treatment will often be decided by industry-embedded state health authorities (guardian consent only lasts as long as the adult child is not reported as violently disruptive). Again, death and injury lawsuits for drug injuries in institutions are easier for victims/families to file if the drug forcibly given was not strictly approved for the condition.

2) Lumping together helps to muddy the "missing adult cohort" search as well as to muddy the fact that autism is statistically more severe in younger cohorts.

When the UK report came out that "1/100" adults had autism, most of those answering the poll could report for themselves, speak on the phone, etc. Chances are, many of these individuals didn't have childhood-onset autism but "symptoms" of autism which emerged from environmental factors, most often psychopharmaceutical drug treatment.

Certain drugs induce OCD, stereotypies, social withdrawal, dementia, language problems, etc., which are uncannily similar to autism. There is a difference in onset and effect but mainstream medical authorities will not be actively trying to differentiate. The effects of some drugs mimic on a cellular level the damage found in autism.

With 11% of adults taking psychiatric drugs, there's a parallel epidemic going on of adult/teen-onset drug-induced dementa which provides an ample pool of adults ripe for diagnoses of "Asperger's", which is very convenient for supporting an "increased diagnosis/no epidemic" stance. Since Asperger's sounds more glamorous than "drug induced dementia" and since patients frequently have to go along with doctors' edicts in order to continue receiving prescriptions for the drugs they're addicted to, many patients will accept the label.

3) Last but not least, lumping diagnoses together is convenient so that people like Ari Ne'eman and other industry-friendly astro-turfing neurodiverse types can be perceived as speaking for/representing "all individuals with autism". Even if the bulk of individuals with autism smear feces, can't live independently, die young and can't even communicate-- much less hold government posts and rub elbows with government officials.

Just my two cents.

Anne McElroy Dachel

Dear Benedetta,

John does not have a job.
I have spent many long and miserable hours at the DVR in my county.
Things are better now because of a new man we've been assigned to help John.

My son is 23 and gets SSI. He has Asperger's and is very gifted. I've told them the
kind of work that would suit John, but they've been intend on getting him jobs in
restaurants and stores---both are places he specifically said he doesn't want to work.

The problem is no one at the DVR has any training and minimal experience with autism.
I've been to so many meetings where I'm the only one in the room who understands what
I'm talking about. I'm hoping things will improve. I really want them to understand what's coming
for them........My son is the tip of the ice berg. Or as I like to say, "How many John Dachels can we
afford to support?"

Best of luck to you!



Anne D:
Does your son have a job?

I was suppose to take my son over to be tested for a state runned vocational rehabilation this morning. It is an hour away over not very good roads to this city, but it snowed and we were going to be half an hour late. When I called to tell them this they said never mind they would rescehedule him. They said they might call next week - with emphasis on MIGHT!!
This scheduled test only took them a month to schedule, but since he goes to class a couple of days it seemed to upset their apple cart. It took calling other people in the vocational rehabiltation - to get permission to do a one day test. (not that I asked them for a one day test, it is what someone decided to do since two days out of the week was not possible).

For five years vocational rehabilation has never mentioned any testing or anything to help.

This past Novemeber after I looked high and low and called back and forth with health insurance and psychologists - I got some testing done. There was a lot of inconsistenceies: for example the psychologist sas my son has superior left hand dexterity - my son can not cursive write and he cannot cut with scissors - he is by the way right handed - It is my fault - I must of made him use his right hand when he was small. Because of these inconsistenceis I spent 400 dollars for a second opinion with a psychiatrist. My advice from both was to travel an hour and half to the big city and get vocational training- which I will pay for and it will be training him to make eye contact and small talk.

But all that is okay because now my son had be tested yet again by the state.

Amy, RN

I don't think that autism, asperger's, pdd-nos, or any other subcategory I may have missed, even belongs in the DSM.

Until autism spectrum disorders are listed as medical, not psychiatric, conditions, they are too easy for the medical community, the insurance carriers, and the politicians to dismiss and ignore.

It's not a REAL health crisis, it's just some meaningless psych thing.

As someone who works in healthcare, I am constantly amazed by the sheer amount of ignorance I find regarding ASD. When colleagues learn that I have a child on the spectrum, they invariably ask, "Oh, are you one of those anti-vaccination nuts?"

And that, sadly, is how we are viewed, because ASD is barely mentioned in nursing school and isn't any better covered in medical school.

Autism isn't a real medical disorder because it's listed in the DSM. I've had physicians tell me this.

The question I ask is, how do we change the classification of ASD and get it out of the DSM and into the medical realm?

Darian (nickname)

I have been saying it all over the web. To do this is a HUGE mistake, for those with autism and with Asperger's! The issues those with Asperger's ACTUALLY HAVE will continue to be ignored, while money iis wasted testing and treating us for everything we DON'T have! So the problems for us remain, plus more money down the drain! Here is what I have been sending out in other places on the web:

"I am very much opposed to the change. I am one of the few who believes that HFA and Asperger’s are not the same thing. And yes, for more than just the early language delay thing.

With Asperger’s, we actually do want to be a part of the rest of society. We want to be able to understand how to be social, how to have ordinary conversations to make friends. We want to be a part of the rest of the world, we just don’t know how.

We look for a bridge between our own world and the world everyone else is in, somewhere we can reach out to your world, and you can reach out to ours.

For those with HFA, those whom I have gotten to know, and I am not wanting to offend anyone it is different. They are very content in thier own world. Whereas they will talk to and socialize with others as much as needed to get along in life, they don’t feel this need to fit in or be a part of society the way someone with AS would. As stated before, they are content in thier world. They like friends, but society as a whole doesn’t hold a lot of meaning for them.

What they are doing is a mistake for many reasons! I understand that parents are wanting services for those with Asperger’s. And this is desperately needed, as I have AS I know this! But we need services that make sense to deal with the issues that we on the other side of the spectrum face! I already have to go through therapies and tests that I don’t need, waisitng tons of state money, because issues that are apart of other kinds of autism. I don’t have these issues. No one that I know with AS does.
But we are put through the tests and therapies anyway.

Meanwhile, in the areas we actually DO need help, there is absolutely nothing!! I see no programs helping the college bound HFA/AS with transitioning from highschool into college. I see no programs to help us find, apply for, learn interview skills for, and keep jobs. As well as communicating with your boss, and your fellow employees.

I see no programs that teach us how to budget, how to balance a check book, how to clean, how to cook, how to spend wisely. No programs on how to deal with and live in society and deal with people in a way that would make it easier to live independently on our own.

I see no help with housing, on helping us learn how to be a part of the community, on helping us cope with anxiety, or helping us understnad what is expected of us by society and why. No, all these services don’t exist. And continue to not even be discussed unless someone like me comes along who forces the issue!

This cookie cutter style of services has got to stop! They already treat almost all of us the same, giving us all the same therapies, same lessons, same benefits, etc. No matter how drasticly different we and our needs are from one another.It’s a waiste of time, money, resources, and continues to allow millions of people to fall through the cracks of our system, with still no help.

This will only make it worse. For along with lumping AS under Autism, they are changing the criteria to better fit it under that area. Which means more will fall through the cracks, even though they have genuine issues that need to be addressed!

I know, parents want to be able to get benefits for thier children. But why are there not programs out there to help and teach us how to transition and help us throughout college or employment so that we can get meaningful jobs and not NEED goverment benefits? Why is it so hard to understand the idea of paying a little now for these services to save alot later when we are able to get along without goverment benefits?

We have got to stop this cookie cutter one size fits all approach to treating a Spectrum of disorders! Especially one as large with such drastic differences as the Autism Spectrum! We have got to start indivudualizing care based off the needs and the goals of each individual on the Spectrum.

And with someone with AS will have needs and issues that are different from someone on the otherside of the Spectrum, to lump us in with those who need different services doesn’t make logical sense and in the end we will be no better off than we are now.

I think we need to keep Asperger’s seperate. That Special Education should instead widen it’s criteria, and supports that truly need to be finally get put into place. And that care and supports be put in place based on the needs of the individual, not all on the Spectrum getting the same treatment and being thought of the same.

That is why the system is failing so miserably now, and after this will continue to fail. Because they don’t get it! THey are doing nothing but going in circles instead of addressing the issues at hand. The “at least we are doing something” mentality is total bs. Because if your something is the wrong thing, nothing will ever change.

This will just make all the special educators, the teachers, staff, case managers, doctors, and therapists to treat us all the same, with the same therapies, treatments, etc even though we do not have the same issues or in some cases the issues that are in the same areas are not as severe as in other types of autism.

No one wants to help with the problems we do have. Everyone wants to treat us for the problems we don’t have.

Maybe it’s just me."


"My name is Isabel and my strength is that I have autism." Like brain damage is a strength. How dumb do they think we are or more to the point how dumb are they! Seriously, who thought this whole ND defemse thing up. Did they think it was a good cover or did they do it to show how stupid some people are. Those of us out in the real world can clearly see that autism is brain damage plain and simple and there ain't nothin' pretty or good about it.

Cathy Jameson

Help me remember...didn't we used to say Grinker is a Stinker from his past articles?

Pill dear?

Psychiatrists are pill pushers today. Glorified pharmacists, except pharmacists know a lot more about the drugs they dispense than psychs do about the drugs they prescribe.

Bob Moffitt

I have said it before .. ad nauseam .. but .. in my humble opinion:

Psychiatry is to medicine .. what astrology is to astronomy.

Robert Smith

Help me out here. My understanding is that Asperger's is mild form of autism, but what I'm gathering is that Asperger's is actually a separate diagnosis. If that's the case, Asperger's kids aren't captured by the 1 in 100 number. Is this correct and wouldn't this largely put to lie the assertion that the increase in autism diagnosis isn't really and increase, it's just reclassifying all these mildly autistics kids?


All stroke victims are the same?

All those with head injuries are the same?

What do you with a child that has classic autism at 3-4 years old (is still non verbal till the third grade), dignosed as PDD-NOS all through middle school to finally aspergers in the middle of high school?

Let us through in a dignosis of tourettes, obsessive compulsive disorder, and I am sure the psy people have a fancy name for them being moody and unreasonably losing their temper and ruining every Thanksgiving/weekend big family meal ever given.

The Psych people just might have a tendency to --- well this study-ology might- could be, a pseudo science hiding behind rearranging words to see how many times and ways they can say the same thing but at different angles and points of view.

I am not sure in the end - it matters

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