DMDD?

[Tap]

DD10 has a DMDD diagnosis and finally a diagnosis that makes total sence!!  Any one else with experience in DMDD?  I have spent 5 hours today researching and my brain is full of information, but not a lot of answers of where to go from here.  It seems like the vast amount of information I find is about comparing it to Bipolar and explaining why it is different.  I want to get more information about DMDD and the different parts of the brain and how they are affected, medications and treatments.  Any suggestions on where to get this information?

 

I don't spend a lot of time on the LC/SN board.....I am usually on the chat board.  I will check back her for a while, but if you reply (especially if it is a few weeks after the post) and I don't respond, feel free to PM me.

Edited April 21, 2017 by Tap

[Crimson Wife]

Looking through the description on the Child Mind Institute site, my immediate and cynical reaction is to wonder if this new diagnosis in the DSM V, like the new "Social Communication Disorder" is going to be given to those who previously would have gotten a diagnosis of Asperger's or PDD.

 

The symptoms of this supposed DMDD sound like the tantrumming and outbursts from those "on the spectrum".

[jewellsmommy]

Looking through the description on the Child Mind Institute site, my immediate and cynical reaction is to wonder if this new diagnosis in the DSM V, like the new "Social Communication Disorder" is going to be given to those who previously would have gotten a diagnosis of Asperger's or PDD.

 

The symptoms of this supposed DMDD sound like the tantrumming and outbursts from those "on the spectrum".

 

I don't have experience from "tantrum" behavior resulting from the spectrum. But I can explain them in DMDD. They mostly result from the individual engaging in cognitive distortions. They are not necessarily all spur of the moment reactions or seemingly random set-offs. 

 

For example: Parent buys child a small blizzard from DQ. Child picks the flavor, is happy at the time. It's explained as being a reward for an excellent therapy session. It's looking like it's going to be a great day. Child eats it all along with a lunch to minimize blood sugar bouncebacks. 2 hours later child becomes destructive, disrespectful, and irritable. After child calms down, you find that the episode was driven by the child ruminating on his reward. He has re-characterized the event as parent taunting/playing with the child because "you (parent) know that I wanted a large. It's my favorite flavor. I never get to have it and then you only get me a small....etc." Re-playing this in his head and spinning it for the last couple of hours has now caused the child to act out because you were mean first.

 

This seems different to me than what I have understood from ASD, but I could be totally wrong because I don't have experience there.

 

OP: Medication and A LOT of therapy on recognizing cognitive distortions (bad thinking) and getting the child comfortable about sharing how they were thinking are the most helpful. This can take a really long time, especially if the child is not motivated or capable about 'seeing' their thoughts and the role that plays. Most of the time the child may just throw some random reason out that makes sense to them, but isn't true. It can be like pulling teeth for them to bare their thinking to you. 

 

They often misinterpret other people's intentions, voice inflections, word choice...etc. For instance, genuine joking/humor is read as sarcasm and elicits a negative mood that may cause a reaction right then and there or may cause child to retreat inward and the result emerges later. Moods shift on a dime form the outside perspective, but it makes complete sense in their head.

 

ETA: Once the triggering event has caused a mood, now you may see more of a senseless, "they're really reaching for reasons" type of outbursts. Of course all children are different and this also depends on other comorbid diagnoses. 

 

Think of it this way, if you had a running tape recorder in your head always spouting how no one really likes you, everyone is mad/mean/sarcastic, you're a victim, they tease you, they talk about you, they think you're dumb, you aren't the problem -they are. They are unfair. .... how would this affect your behavior?

 

The biggest triggers in my experience: (the obvious one) child doesn't get his/her way/want.

 

Child gets embarrassed (maybe for a real reason, maybe an imagined slight) such as drawing a smiley face on the plain bandaid was really the parent mocking the child for needing a bandaid.  

 

Child perceives an unfair situation, injustice. This was such a big one: if this child has a loss of privilege, then everyone in the family should. It doesn't matter who did the crime. If he no longer has access to his Nintendo DS (because he literally ripped it in half) then the other child in the house should lose hers because otherwise it's not fair.

 

Sometimes having the child identify the cognitive distortions in other people is a less threatening way to start the process, but it is really hard to then make the jump to themselves. 

Edited April 21, 2017 by jewellsmommy

[Tap]

I can see why from the description it would look similar to Aspergers, but for us, it looks quite different.

 

 

DD has 5 diagnoses. Autism, DMDD, ADHD, neuro-develepement disorder (low IQ), fine more skills delay.  These were all issued from 2 separeate neuropsych evals done 2 years apart, by different examiners. The both gave her the same 5dx.  The DMDD was first noted on her last eval, but since it was a new dx in DSM5, it was downplayed.  Honestly, I forgot it was in her eval.

 

 

This 2nd eval (last month) the exminer was able to better explain the dx.

 

After having 2 years for me to better understand everything, and the new Dr confirming the dx. I started researching again.

 

She has seen autism specialists for 6 years.  There are some of her traits that are absolutely autistic. But there is also an underlying irritation, that never made sense.  It is unprompted and there s often no known reason for it.  It is like someone flips a switch and she turns into a spite-filled, venom spewing, hateful, child. Her tone  of voice, words she choses, and body language aren't just because she is missing/misunderstanding social cues.  She can flip like a light switch....between being a normal 10yo, who is laughing and joking....to a horrid, mean spirited person who is infuriating, offensive and angry. 

 

She has had 2 therapists discharge her form their practices due to her unpredictable rage. They didn't feel safe anymore.

 

 

2 nights ago, I handed her dinner plate and she jerked it out of my hand and threw the food across the floor....all because I called her inside for dinner.  She didn't complain about being called in. She had put her bike away as asked, walked in the kitchen and stopped to get her plate. (She didn't like what we were having so I made her a dinner she would like, so that wasn't it).  It wasn't until I handed her the plate, that she just flipped a switch and her Dr Jeckle /Mr Hyde personality flipped. She was instantly in a rage.  Not angry....a full on rage.  She had an half-hour long, screaming at the top of her lungs rage filled episode.

 

She gets extremely irrational/irritable over simple little things, and sometimes there are no visible triggers. 

 

Her autistic traits will make her recoil and draw into he self. She may get accidental violent, but it is more sensory seeking than purposeful.  She may slam chairs around or hide under a table.  She will rip up a book, or ignore instructions to stop doing something.

 

The rage from her other behaviors is aggressive and without remorse.  She has kicked holes in walls, broke sturdy furniture, broke a metal school door, broke my nose, stabbed a teachers hand with a pencil, jumped on a teachers back and injured her neck (dd is 160lbs) I can go on and on.....all over things that were disappointing, but very, very minor things to a NT kid (given wrong color of construction paper, found out a friend wasn't home to play, etc).

 

She can be sweet as pie, funny, charming and loving.  And then she can turn on you and be soooo irritable. Then be happy again 10 minutes later. She is irritable as much as she is happy.  Imagine the worst anger filled, unpredictable PMS that you can. She will twist words and change what people mean.  She can tell a joke, and you laugh at the joke, and then she will be pissed off that you laughed AT her.  Never mind that she purposefully told a joke...she might see reality....or misconstrue it as a purposeful slight.    You can offer her ice cream and ask what flavor she wants.....then get a diatribe......because of course she wants vanilla because she always eats vanilla and how dare you waste her having to explain that to you and now her ice cream is going to be melted because you had the freezer open for 30 seconds. Then you get the angry instructions, to not only give her 1 small scoop, to make sure it is a big scoop like she deserves. (By the way she also eats other flavors and you give her the same amount each time). So you dish her ice cream, and she says thanks, gives a hug and runs off to the other room to watch a tv show.

 

The whole interchange happens over 2 minutes and then the switch flipped back to normal and she is fine again.  In a NT kid you would have never given them the ice cream after the diatribe, but this is just how her brain works. She has had 300 behavior therapy sessions and 250 Occupational Therapy to get to this point!

 

 

it is wayyyy more than Aspergers.

[Ottakee]

That is a new one on me. We have mood disorder NOS and Bipolar 1 here. Lamictal, Lithium, and Risperdal in combo with a small dose Dexedrine has given us almost complete stability.

 

I know the treatments for what you have are still evolving. Sorry I don't know more.

[Ottakee]

Just another thought....Has she been tested for mitochondrial disorders? All of her diagnosis could fit under that umbrella.

[PeterPan]

When I googled it, I thought they were saying they didn't diagnose it separately if ASD was present, so that's interesting that multiple places have done DMDD and ASD comorbid.

 

I think the trouble, or the thing I wonder about (because my ds is pretty astonishing too), is what the actual PHYSICAL cause is. As Ottakee says, that's the really curious question. The DSM is just saying that symptom exists. It's not giving you an EXPLANATION. Methylation issues? Previous trauma leading to a really high fright/flight rate and constantly high cortisol? 

 

I really think you're right that if it's a body thing going on, something metabolic, something physical, then ABA isn't going to tame it. That's what we see with my ds. You can pull out all the ABA techniques you want, but you'd have to get abusive and squash his soul. They don't actually solve the stuff that goes on in him. It's extra, and it's clearly physical. 

 

For him, the reflex work helps. Niacin seems to help. We're also talking with someone who uses TRE (Trauma Release Exercises) with these kids. TRE is free, so it would be pretty fascinating to see what would happen. You'd probably want to consider a therapist experienced in doing TRE with autism, if you could find it. Apparently you can do it even with cognitive disabilities, etc. It would be getting to the physical imbalance behind the reactivity. 

 

At least it's something free and different you haven't tried.

[PeterPan]

Also, I find it really frustrating that they take a picture of what autism looks like with low IQ and then go oh that's the autism and then say whatever happens with the higher IQ ASD kid is a mental disorder. Really? Or is it actually shades of the overall picture? I don't have data on that. I'm just saying I meet some really easy-going lower IQ ASD kids and the higher IQ ones seem to be pretty high strung. 

 

I have no clue. It's stuff I just keep thinking through and trying to notice myself. But our behaviorist says that too, that the lower IQ kids do have that easier response and the higher the IQ the harder it's going to go.

 

But I agree, straight ABA (implying if they were motivated and you put in enough structure they could do it) isn't getting them there. Something physical is going on. But the DSM doesn't give a rip about physical. It just lobs out these labels by symptoms. 

[OneStepAtATime]

I have no knowledge that would help but I wanted to send hugs.  Dealing with that must be so exhausting and ... I don't even know what word to use.  Especially with no easy answers.   :grouphug:  :grouphug:  :grouphug:

[Tap]

That is a new one on me. We have mood disorder NOS and Bipolar 1 here. Lamictal, Lithium, and Risperdal in combo with a small dose Dexedrine has given us almost complete stability.

 

I know the treatments for what you have are still evolving. Sorry I don't know more.

Who do you go to for the testing?  What to ask for?  I live outside Portland Oregon so there are specialists her for pretty much every field, I just don't know where to start.

 

Her PCP only sees her for a general physical and if she is sick. She sees him roughly once per year.  Her psychiatrist is leaving the community health practice she has seen him at for 6 years.  They don't have a replacement yet, so there will be very basic med management for probably a year or longer. (They already had a job opening for a year, and now they are losing him too).

[Guest]

I have two on the spectrum, one with Asperger's, that sounds *nothing* like my two. Nothing I have read about autism and Asperger's (and I have read a lot) would make this description sound like Asperger's!

 

With the new ADOS (adjusted to the new DSM), you could have someone with Asperger's given a level two. Just because Asperger's does not have the language delays, it does not mean you will not have more severe cases of Asperger's. In that sense, I actually give credit to the new DSM. This sounds totally different though!

 

Tap, :grouphug: :grouphug: :grouphug:

I can't even begin to imagine how difficult this must be for you!

Edited April 21, 2017 by Guest

[Tap]

When I googled it, I thought they were saying they didn't diagnose it separately if ASD was present, so that's interesting that multiple places have done DMDD and ASD comorbid.

 

I think the trouble, or the thing I wonder about (because my ds is pretty astonishing too), is what the actual PHYSICAL cause is. As Ottakee says, that's the really curious question. The DSM is just saying that symptom exists. It's not giving you an EXPLANATION. Methylation issues? Previous trauma leading to a really high fright/flight rate and constantly high cortisol? 

 

I really think you're right that if it's a body thing going on, something metabolic, something physical, then ABA isn't going to tame it. That's what we see with my ds. You can pull out all the ABA techniques you want, but you'd have to get abusive and squash his soul. They don't actually solve the stuff that goes on in him. It's extra, and it's clearly physical. 

 

For him, the reflex work helps. Niacin seems to help. We're also talking with someone who uses TRE (Trauma Release Exercises) with these kids. TRE is free, so it would be pretty fascinating to see what would happen. You'd probably want to consider a therapist experienced in doing TRE with autism, if you could find it. Apparently you can do it even with cognitive disabilities, etc. It would be getting to the physical imbalance behind the reactivity. 

 

At least it's something free and different you haven't tried.

They left both dx in place because they do not think these specific behaviors are due to her Autism dx..  They present differently and her autism specialists both agree.  When working directly with dd, her Autistic traits are identifiably different than these rage/irritation episodes.

 

From the DSM V (so others know what we are talking about)

 

 

 

J. The behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental disorder (e.g., autism spectrum disorder, posttraumatic stress disorder, separation anxiety disorder, persistent depressive disorder [dysthymia]).

Edited April 21, 2017 by Tap

[Guest]

Tap, you have probably already come across these but I'll link them just in case

 

https://www.nimh.nih.gov/health/topics/disruptive-mood-dysregulation-disorder-dmdd/disruptive-mood-dysregulation-disorder.shtml

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357333/

[PeterPan]

Neurologist for the mito I think.

[Ottakee]

Neurologist for the mito I think.

Yes, our neurologist ordered the tests. Thankfully they are just blood tests now.

[Guest]

nm 

 

Edited August 14, 2017 by Guest

[Guest]

deleted for privacy

Edited August 14, 2017 by Guest

[Crimson Wife]

I don't have experience from "tantrum" behavior resulting from the spectrum. But I can explain them in DMDD. They mostly result from the individual engaging in cognitive distortions. They are not necessarily all spur of the moment reactions or seemingly random set-offs. 

 

For example: Parent buys child a small blizzard from DQ. Child picks the flavor, is happy at the time. It's explained as being a reward for an excellent therapy session. It's looking like it's going to be a great day. Child eats it all along with a lunch to minimize blood sugar bouncebacks. 2 hours later child becomes destructive, disrespectful, and irritable. After child calms down, you find that the episode was driven by the child ruminating on his reward. He has re-characterized the event as parent taunting/playing with the child because "you (parent) know that I wanted a large. It's my favorite flavor. I never get to have it and then you only get me a small....etc." Re-playing this in his head and spinning it for the last couple of hours has now caused the child to act out because you were mean first.

 

This seems different to me than what I have understood from ASD, but I could be totally wrong because I don't have experience there.

 

OP: Medication and A LOT of therapy on recognizing cognitive distortions (bad thinking) and getting the child comfortable about sharing how they were thinking are the most helpful. This can take a really long time, especially if the child is not motivated or capable about 'seeing' their thoughts and the role that plays. Most of the time the child may just throw some random reason out that makes sense to them, but isn't true. It can be like pulling teeth for them to bare their thinking to you. 

 

They often misinterpret other people's intentions, voice inflections, word choice...etc. For instance, genuine joking/humor is read as sarcasm and elicits a negative mood that may cause a reaction right then and there or may cause child to retreat inward and the result emerges later. Moods shift on a dime form the outside perspective, but it makes complete sense in their head.

 

ETA: Once the triggering event has caused a mood, now you may see more of a senseless, "they're really reaching for reasons" type of outbursts. Of course all children are different and this also depends on other comorbid diagnoses. 

 

Think of it this way, if you had a running tape recorder in your head always spouting how no one really likes you, everyone is mad/mean/sarcastic, you're a victim, they tease you, they talk about you, they think you're dumb, you aren't the problem -they are. They are unfair. .... how would this affect your behavior?

 

The biggest triggers in my experience: (the obvious one) child doesn't get his/her way/want.

 

Child gets embarrassed (maybe for a real reason, maybe an imagined slight) such as drawing a smiley face on the plain bandaid was really the parent mocking the child for needing a bandaid.  

 

Child perceives an unfair situation, injustice. This was such a big one: if this child has a loss of privilege, then everyone in the family should. It doesn't matter who did the crime. If he no longer has access to his Nintendo DS (because he literally ripped it in half) then the other child in the house should lose hers because otherwise it's not fair.

 

Sometimes having the child identify the cognitive distortions in other people is a less threatening way to start the process, but it is really hard to then make the jump to themselves. 

 

All of the bolded sound like ASD inflexibility and perseveration to me.

[Crimson Wife]

 

She has seen autism specialists for 6 years.  There are some of her traits that are absolutely autistic. But there is also an underlying irritation, that never made sense.  It is unprompted and there s often no known reason for it.  It is like someone flips a switch and she turns into a spite-filled, venom spewing, hateful, child. Her tone  of voice, words she choses, and body language aren't just because she is missing/misunderstanding social cues.  She can flip like a light switch....between being a normal 10yo, who is laughing and joking....to a horrid, mean spirited person who is infuriating, offensive and angry. 

 

She has had 2 therapists discharge her form their practices due to her unpredictable rage. They didn't feel safe anymore.

 

 

2 nights ago, I handed her dinner plate and she jerked it out of my hand and threw the food across the floor....all because I called her inside for dinner.  She didn't complain about being called in. She had put her bike away as asked, walked in the kitchen and stopped to get her plate. (She didn't like what we were having so I made her a dinner she would like, so that wasn't it).  It wasn't until I handed her the plate, that she just flipped a switch and her Dr Jeckle /Mr Hyde personality flipped. She was instantly in a rage.  Not angry....a full on rage.  She had an half-hour long, screaming at the top of her lungs rage filled episode.

 

She gets extremely irrational/irritable over simple little things, and sometimes there are no visible triggers. 

 

Her autistic traits will make her recoil and draw into he self. She may get accidental violent, but it is more sensory seeking than purposeful.  She may slam chairs around or hide under a table.  She will rip up a book, or ignore instructions to stop doing something.

 

The rage from her other behaviors is aggressive and without remorse.  She has kicked holes in walls, broke sturdy furniture, broke a metal school door, broke my nose, stabbed a teachers hand with a pencil, jumped on a teachers back and injured her neck (dd is 160lbs) I can go on and on.....all over things that were disappointing, but very, very minor things to a NT kid (given wrong color of construction paper, found out a friend wasn't home to play, etc).

 

She can be sweet as pie, funny, charming and loving.  And then she can turn on you and be soooo irritable. Then be happy again 10 minutes later. She is irritable as much as she is happy.  Imagine the worst anger filled, unpredictable PMS that you can. She will twist words and change what people mean.  She can tell a joke, and you laugh at the joke, and then she will be pissed off that you laughed AT her.  Never mind that she purposefully told a joke...she might see reality....or misconstrue it as a purposeful slight.    You can offer her ice cream and ask what flavor she wants.....then get a diatribe......because of course she wants vanilla because she always eats vanilla and how dare you waste her having to explain that to you and now her ice cream is going to be melted because you had the freezer open for 30 seconds. Then you get the angry instructions, to not only give her 1 small scoop, to make sure it is a big scoop like she deserves. (By the way she also eats other flavors and you give her the same amount each time). So you dish her ice cream, and she says thanks, gives a hug and runs off to the other room to watch a tv show.

 

The whole interchange happens over 2 minutes and then the switch flipped back to normal and she is fine again.  In a NT kid you would have never given them the ice cream after the diatribe, but this is just how her brain works. She has had 300 behavior therapy sessions and 250 Occupational Therapy to get to this point!

 

 

it is wayyyy more than Aspergers.

 

Again, the bolded strikes me as ASD. My daughter is sweet and affectionate most of the time but if she gets her mind fixated on something and it doesn't happen, that sets off a horrible outburst. ABA has really helped to reduce the frequency because it has helped improve her flexibility. But it hasn't totally eliminated the tantrumming.

 

[Guest]

nm

Edited August 14, 2017 by Guest

[jewellsmommy]

All of the bolded sound like ASD inflexibility and perseveration to me.

 

I don't doubt you as I have no experience with ASD. But the child I described has been through many psychologists and does not fit a diagnosis on the spectrum. So I guess when you're not on the spectrum they call this collection of behaviors a mood dysregulation disorder.

[Guest]

I don't doubt you as I have no experience with ASD. But the child I described has been through many psychologists and does not fit a diagnosis on the spectrum. So I guess when you're not on the spectrum they call this collection of behaviors a mood dysregulation disorder.

Some of the differences with these new labels have a lot to do with intensity and frequency of the specific patterns of behavior. Also, just because a child exhibits specific patterns of behavior similar to ASD, it does not mean that the child ticks enough of the other categories to justify an autism diagnosis. This appears to be the case here.

[Tap]

Again, the bolded strikes me as ASD. My daughter is sweet and affectionate most of the time but if she gets her mind fixated on something and it doesn't happen, that sets off a horrible outburst. ABA has really helped to reduce the frequency because it has helped improve her flexibility. But it hasn't totally eliminated the tantrumming.

 

Even her ASD specialists think there is something more going on than Autism.  The intensity and rage, isn't just a confused child striking out in anger.  It is full on, teeth baring, black eyed rage.  Her top level doctors/therapists are really challenged by her.  She has exceeded the care of several providers. When she is agitated and angry....that is possibly the Autism.  The rage...is something different.  That is why they are thinking DMDD. 

 

(DD10 is my niece and has a genetic predisposition towards several significant mental health dx. She is also likely drug affected.)

[Ottakee]

What is the current treatment guidelines for this?

[Guest]

What is the current treatment guidelines for this?

Treatment and therapies are listed in the previous links I posted. Here's one:

 

https://www.nimh.nih.gov/health/topics/disruptive-mood-dysregulation-disorder-dmdd/disruptive-mood-dysregulation-disorder.shtml

 

Quoting a portion but the link has more details on meds and specific therapies.

 

"Treatment and Therapies

 

DMDD is a new diagnosis. Therefore, treatment is often based on what has been helpful for other disorders that share the symptoms of irritability and temper tantrums . These disorders include attention deficit hyperactivity disorder (ADHD), anxiety disorders, oppositional defiant disorder, and major depressive disorder.

 

If you think your child has DMDD, it is important to seek treatment. DMDD can impair a child’s quality of life and school performance and disrupt relationships with his or her family and peers. Children with DMDD may find it hard to participate in activities or make friends. Having DMDD also increases the risk of developing depression or anxiety disorders in adulthood.

 

While researchers are still determining which treatments work best, two major types of treatment are currently used to treat DMDD symptoms:

 

Medication

Psychological treatments

Psychotherapy

Parent training

Computer based training

Psychological treatments should be considered first, with medication added later if necessary, or psychological treatments can be provided along with medication from the beginning.

 

It is important for parents or caregivers to work closely with the doctor to make a treatment decision that is best for their child."

Edited April 23, 2017 by Guest

[Guest]

Edited for privacy. 

 

Hope you find the best treatment plan for your girl, Tap :grouphug: I don't have the rage but my 8 yr old's energy level is exhausting. It does not compare to what you are going through but I just wanted to say that after reading a bit about DMDD, I sympathize :grouphug:

 

Edited August 14, 2017 by Guest

[nature girl]

With your daughter's background, has RAD been suggested? The symptoms you describe sound similar to what I've read for RAD, and also potentially similar to FAS. (I looked both up awhile ago when someone here suggested they might be behind some of my adopted DD's issues.) It might make sense to have her seen by an RAD specialist, to tease out whether there's more going on. RAD can present as autism

 

I probably am wrong, but I've always had the feeling, as others have implied upthread, that they put the relatively new DMDD label on kids who may instead actually have a mix of other issues, such as SPD plus bipolar (which presents differently in kids), ASD with severe SPD and ODD, etc. In any case, if there's a chance of RAD in the mix, they'd probably recommend attachment parenting, and the recommended therapy would be somewhat different.

 

:grouphug: This does sound so difficult. Bless you for taking her in.

[Guest]

I think these new labels are useful or at least a step in the right direction. There's a lot more to mental health issues, beyond the preexisting labels. How many times have we found it puzzling to hear about supposedly cured autistic kids? Some mental health issues are also not permanent and respond differently to treatments than those that are. Clearly, a lot more needs to be factored in than what was, previously. It is sometimes difficult to see positives in change until a certain length of time has passed. It is also why there is a need for the DSM to be revised every few years.

Edited April 24, 2017 by Guest

[Crimson Wife]

I think these new labels are useful or at least a step in the right direction. 

 

They're not a step in the right direction when they are being used to deny needed services that would be mandated if the old labels were still available to give. Eliminating Asperger's and PDD as diagnoses in favor of all these new ones that are not subject to autism mandates strikes me as the medical establishment trying to save $$$$ for insurance companies and school districts at the expense of kids who need help. :thumbdown: :thumbdown: :thumbdown:

[Guest]

They're not a step in the right direction when they are being used to deny needed services that would be mandated if the old labels were still available to give. Eliminating Asperger's and PDD as diagnoses in favor of all these new ones that are not subject to autism mandates strikes me as the medical establishment trying to save $$$$ for insurance companies and school districts at the expense of kids who need help. :thumbdown: :thumbdown: :thumbdown:

I don't view it that way. I think it's a good step that can lead to more targeted interventions. While I am not impressed about Asperger's being removed as a distinct diagnosis (I don't know enough about PDD to judge), those with Asperger's requiring supports should still qualify under the new DSM levels. The services provided are something that needs mandating based on level of severity with these new labels, and the parents need to have options on the therapies. If insurance companies are using this as a basis to deny services then something needs to change there! That's separate from the DSM.

[Guest]

How many people are affected by SPD? If they don't have an autism label they get no services. Should we give them all autism labels just so they can have services? Obviously, these new distinct disorders need to be identified first so that new mandates can be put in place.

[kbutton]

The rage is something I've heard about from other adoptive parents as well. 

 

Regardless of the outcome or cause, I hope you are able to find a professional that has a broad enough background to take this in and give excellent advice.