By Kathryn Wicks
A year from now, my six-year-old son will no longer have autism. But I have not discovered a miracle cure - nor do I feel like jumping for joy.
The criteria for an autism diagnosis, as defined by the authors of the Diagnostic and Statistical Manual of Mental Disorders (DSM), is about to change so dramatically that parents across the world are fearful children classified as having high-functioning autism, Asperger's syndrome or pervasive development disorder are likely to lose their diagnosis - and with it, their therapy and educational entitlements.
It is teachers who should be complaining the loudest. They will be the ones left to manage untreated children with less help from special needs staff because fewer children will be classified as special needs.
Parents and psychologists fear the changes to the diagnostic criteria are driven by an American government wanting to reduce the rate at which autism is diagnosed - now one in 100 - so as to reduce the cost of supporting services which help children with an autism spectrum disorder (ASD) fit into society, and the classroom.
The clinicians on the DSM taskforce claim changes to the manual will not change the rate of diagnosis. They argue they are simply trying to reduce the subcategories and cover all afflicted children with one blanket label, autism spectrum disorder, to achieve better clarity on diagnosis.
But the devil lies in the detail of the changes between the present manual and the proposed new manual, to come into effect next year, and experts fear a large drop in the number of diagnoses.
A diagnosis of ASD, which can include the subcategories such as Asperger's, is given if a child ticks enough boxes across three categories of impairment - social interaction, speech and language, and behaviour. Each category has four ''boxes''.
Now, a diagnosis of ASD is allowed if six of the 12 impairments are present, two of which must be impairments in social interaction. Under the proposed changes, a child will need to have all four social interaction deficiencies before a diagnosis is given. In the second category, communication, a diagnosis now requires one deficiency; under the changes, it will require two.
According to Professor Allen Francis, the chairman of the taskforce responsible for the present manual, to gain a diagnosis, there are 2688 possible combinations of the 12 deficiencies.
However, under the changes, there will be only six possible combinations. ''The method of deriving the new DSM-5 criteria is suspect and its claim to be rate neutral seems simply absurd,'' Frances wrote in the Huffington Post.
And he is dead right. Diagnosis rates, especially for high-functioning and Asperger's children, will fall dramatically. I know my son ticks six of those 12 boxes, but under DSM-5, he will not tick the right six boxes. He will be reclassified as having a ''social disorder'', not an autism spectrum disorder. It won't change his life; he has used his funding and successfully made the transition to mainstream school.
But what will it do to an equally afflicted child who fails to get a diagnosis in future? Will he learn to say ''mum'' and look her in the eye? Will he learn to use his nice voice when talking to his friends? Will he learn to share toys? Will he learn to cope with a routine being thrown out? Will he be able to sit still in class, listen and learn? Without therapy, probably not.
In Australia, a child diagnosed with any ASD is entitled to funding of $12,000 over two years up to age six, paid directly to service providers of multidisciplinary therapy. Such therapy may include applied behaviour analysis (ABA) therapy, occupational therapy, and speech therapy. It doesn't cover the cost, but it helps. The result of the therapy, especially ABA, is priceless, often getting autistic children across the line into mainstream schooling.
This funding means children are getting help when it helps them most - ages two to five, when the brain is described as being more ''plastic'' and thus more influenced by therapy. By the time they get to school, provided they have their two years of therapy, a child with autism but a normal IQ is often able to function in a normal classroom environment (as long as no one moves his pencils out of place). ABA teaches children to behave appropriately through the consistent and exhaustive reinforcement of good behaviour over a sustained period. It works.
Take therapy away, and Kindy Blue turns into Kindy Beirut pretty quickly.
Teachers and all parents should picture this: in 2018, a teacher could be dealing with a child with untreated ''social disorder'' rolling around the floor and refusing to sit at his desk, not teaching the other 19 neurologically normal children in the room.
The time to speak up is now.
--- Kathryn Wicks is a senior Sydney Morning Herald journalist and her piece originally appeared HERE.