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"It's Not a Big Deal...They're Literally Only Changing 1 Word"

There's been a bit of a backlash to the folks like us who see the current DSM revision as a big deal for the autism community. Let me remind you why it matters.

Any text revisions that occur between releases of numericial volumes are typically considered minor, but also establish guidelines for the direction of presently accepted ideas on these conditions. We remain concerned about the implications of these supposedly minor changes as we lead into a period of revising for DSM-6.

It's Ensconced in the Foundations of Clinical Education

Every doctor, clinician, counselor, therapist, social worker, or psychiatric practitioner in the West is educated on the latest Diagnostic and Statistical Manual of Mental Disorders.

In my school, we have a test on each of the disorders and their diagnostic criteria; we have to memorize them verbatim and demonstrate that we can implement them in cases as per DSM guidelines. It's at the foundation of our training in becoming diagnosticians of psychiatric illness.

When we make even small changes like this to foundational manuals like the DSM—changes that have been explicitly stated to be in the interest of reducing the prevalence rate of autism diagnosis—there is a trickle down effect on the clinical community. Every clinician that comes after us is beholden to that text. If the major institution behind that text (American Psychiatric Association) wants to impose stricter limits on our ability to give a diagnosis (and have those services be covered by insurance boards and government subsidies) then, as clinician advocates, we are in a bit of trouble when it comes to routing autistic people to proper therapy, community supports, and accommodations.

Healthcare Inequities Abound

If you can't get a diagnosis, you can't get insurance or government assistance to cover treatment for that condition. If giving an autism diagnosis to a broad range of presentations is poo-pooed by the psychiatric field, many people will not even be able to evaluated for a diagnosis in the first place. Not everyone has $1000+ dollars to invest in a private diagnostic workup. Not everyone has equal access to diagnosis in the first place. It's a massive systemic issue. It is a big deal.

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