Neurodiversity and Early Autism—Reply

Dawson, Geraldine; Franz, Lauren; Brandsen, Sarah

doi:10.1001/jamapediatrics.2022.4147

Cited by 1 publication

(1 citation statement)

References 4 publications

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“…It remains to be seen how clinicians who are not familiar with ASD will receive this conceptualization that is moving further away from an observable, behavioral, and neurodevelopmental disorder (medical model) to a disorder of inner experience in sense of "diversity" and "identity" (social model). There are several controversies surrounding the social model and consequences of early intervention methods [50][51][52][53][54]. This is an important and necessary but it seems questionable that a classification system is the appropriate instrument for addressing this open debate, as the Advisory Group emphasized that the focus of the ICD-11 was on the classification of disorders and not the assessment and treatment of individuals ([55], p. 91).…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Autism spectrum disorder in ICD-11—a critical reflection of its possible impact on clinical practice and research

Kamp-Becker

2024

Mol Psychiatry

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This perspective article compares and contrasts the conceptualization of Autism Spectrum Disorder (ASD) in ICD-11 and DSM-5. By guiding the user through the ICD-11 text, it is argued that, in contrast to DSM-5, ICD-11 allows a high variety in symptom combinations, which results in an operationalization of ASD that is in favor of an extreme diverse picture, yet possibly at the expense of precision, including unforeseeable effects on clinical practice, care, and research. The clinical utility is questionable as this conceptualization can hardly be differentiated from other mental disorders and autism-like traits. It moves away from an observable, behavioral, and neurodevelopmental disorder to a disorder of inner experience that can hardly be measured objectively. It contains many vague and subjective concepts that lead to non-falsifiable diagnoses. This bears a large danger of false positive diagnoses, of further increased prevalence rates, limitations of access to ASD-specific services and of increasing the non-specificity of treatments. For research, the hypothesis is that the specificity of ASD will be reduced and this will additional increase the already high heterogeneity with the effect that replication of studies will be hampered. This could limit our understanding of etiology and biological pathways of ASD and bears the risk that precision medicine, i.e., a targeted approach for individual treatment strategies based on precise diagnostic markers, is more far from becoming reality. Thus, a more precise, quantitative description and more objective measurement of symptoms are suggested that define the clinical ASD phenotype. Identification of core ASD subtypes/endophenotypes and a precise description of symptoms is the necessary next step to advance diagnostic classification systems. Therefore, employing a more finely grained, objective, clinical symptom characterization which is more relatable to neurobehavioral concepts is of central significance.

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Section: Implications For Clinical Practicementioning

confidence: 99%

Autism spectrum disorder in ICD-11—a critical reflection of its possible impact on clinical practice and research

Kamp-Becker

2024

Mol Psychiatry

View full text Add to dashboard Cite

show abstract

Neurodiversity and Early Autism—Reply

Cited by 1 publication

References 4 publications

Autism spectrum disorder in ICD-11—a critical reflection of its possible impact on clinical practice and research

Autism spectrum disorder in ICD-11—a critical reflection of its possible impact on clinical practice and research

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