[NeuroCoder]

The problem was that a diagnosis of Asperger's was unreliable and therefore useless. We definitely need to identify individuals within the diagnosis of autism spectrum disorder that can reliably be identified and benefit from specific interventions. However, Asperger's did not provide that.

[faeriechangling]

No, the problem was that psychiatrists could bill insurers more to treat autism than they could Asperger's. You aren't cynical enough.

If it wasn't a scientific distinction, why are we still identifying autism subtypes?

[didufis]

I think this is precisely why for-profit healthcare is wild. If it weren’t for ideology we could get behind socialised care and cut out all of the nonsense.

[TeaBrain]

Do you have any information on patients could be billed more for an autism diagnosis? I've never heard this claim before.

[faeriechangling]

Mostly anecdotal, my school psychologist back in the day sure believed it, and this would vary from place to place. She was a champion of "You give children the diagnosis that gives them the services they need". Autism being the one which gave children the services they needed, and she often expressed frustration at not being able to get such a diagnosis.

In general Aspergers basically meant no verbal delays, where Autism meant verbal delay. Autism was also around longer as a diagnosis. In general, I think theres a reason they changed the name of Aspergers to Autism and not the other way around.

[TeaBrain]

Interesting that the diagnosis of autism apparently wasn't available to her. Do you know what she would have been referring to by the autism diagnosis being able to get children the services they needed, that the "asperger's" diagnosis would not?

[spondylosaurus]

I thought they changed the name in part because Hans Asperger was a Nazi collaborator.

[NeuroCoder]

It can be helpful to get a diagnosis of autism for kids in public school. Kids end up needing additional one on one time and resources are limited. Those with the biggest problems are the first to be approved for these resources, and a formal diagnosis makes it easier to get that approval.

[TeaBrain]

>diagnosis of Asperger's was unreliable and therefore useless

If this is true, then in what way is the diagnosis of autism reliable, that the Asperger's label was not?

[NeuroCoder]

Asperger's was not reliably diagnosable between healthcare workers trained to diagnose it. In other words, a diagnosis of Asperger's in someone's medical chart was not a reliable way of knowing if they had Asperger's.

[TeaBrain]

This isn't really providing any clarity to the question, since you're simply restating your previous claim. How is a diagnosis of autism any more reliable?

[NeuroCoder]

As in it has a higher inter rater reliability. The statistical term of reliability that is used when describing the likelihood to reproduce a measure under similar conditions.

[TeaBrain]

What matters here is not the general inter-rater reliability for all autism diagnoses, but only those for the patients which would have otherwise been described as having Asperger's, which can often present as a very mild disorder. Given that many Asperger's cases are mild, it is no surprise that there is low inter-rater reliability. Is there evidence that for this type of individual, there is a higher inter-rater reliability with the diagnosis of "autism"?

[TeaBrain]

I'd argue that having the descriptor of "asperger's" is much more useful than simply having a blanket descriptor of "autism". Low functioning people who are described as having autism, have very little in common with most of the high functioning type.

[seba_dos1]

> have very little in common

[citation needed]

[TeaBrain]

Do you really need a citation that a non-verbal, uncommunicative and non-independent "non-functional" traditional autism case is different from what would often be referred to as "Asperger's", which is common amongst software developers? Or take people like Elon Musk, Bill Gross and David Byrne, who all claim to have Asperger's, Bill and David having been formally diagnosed. These people, who achieved great success, and went through most of their lives without needing a diagnosis, are clearly nothing like the non-functional patients with clearer traditional cases of autism.

[seba_dos1]

First you claimed that they "have very little in common", and now merely that it "is different"... although in the next sentence you go back to "clearly nothing like"?? You seem quite undecided about what you actually want to say.

They're obviously "different", but there's plenty of reasons to believe that they have a lot in common, so going against established science should require some citations.

[throwawaymaths]

The problem was that asperger was a problematic physician at best.