Autism Spectrum Disorder, or ASD, is a condition that affects behavior primarily. There are some physical symptoms associated with it, gastrointestinal inflammation being a very common occurrence among those diagnosed with ASD, but what the condition is most well-known for is the way it affects the behavior of the person. Because it is a condition, and not a disease or infection, such as pneumonia, there is no injection, antibiotics, or other treatment that can cure ASD. The symptoms can only be diagnosed, assessed, and then managed.
Because this is one of the key factors for getting good treatment for ASD is proper classification. If you don’t know what you’re dealing with, you won’t know how to treat it. This has been one of the biggest hurdles to those with ASD getting the help they needed. For example, it was only in the 1980s that ASD was even recognized as a disorder; before that, people with the conditioned were diagnosed as being schizophrenic.
This was problematic for many years because some people with ASD can, and do, respond positively to the prescription of antipsychotics, but it is not appropriate for everyone. This is one of the reasons why classifying and categorizing ASD has, in recent years, become more comprehensive and accurate.
Another example of this is ICD 10 and the diagnosis of severe autism. So what is ICD 10? Why and how is it being used?
An Administrative Standard
ICD stands for International Classification of Diseases, and it is created by the World Health Organization. The ICD-10 standard being discussed was delayed by several years, due to many objections from both American medical and insurance organizations. The objections were raised because of the growing complexity of the ICD system, as well as the ways it complicated an activity of particular importance to the USA, billing for insurance companies.
While the rest of the world uses the ICD system primarily for diagnosis, the USA also relies on it for classifying and approving the payment of medical services from medical insurance companies. Despite the USA being in the minority compared to the rest of the world for what the ICD system was primarily used for, it wasn’t until the medical and insurance organizations of America were satisfied that the ICD’s 10th iteration, known as ICD-10, finally went into general release in 2013.
The Billing Issue
This means that by creating a standard, regarding diseases and other conditions, with a listing of what treatments are normally expected, insurance companies can more quickly determine whether all appropriate actions have been taken to pay—or not pay—on medical bills.
For example, if pneumonia were designated as T16, then this simple alphanumeric code is much easier to fill in forms, both paper and digital. It makes it easy to consult what the symptoms of T16 are, what the appropriate treatments are, and both doctors and insurance companies can check to see if all the “boxes” required for treating T16 have been met. If so, normal bureaucratic and financial actions, such as medical insurance covering payments, can now take place.
The ASD Designation
In the case of ASD, the general condition of autism is designated as F84. One important thing to note is that the ICD-10 designation is already out of date. In 2018, WHO released the ICD-11 classification system, so ICD-10 is already out of date, especially since it used the older forms of categorization that another American medical reference, the Diagnostic & Statistical Manual of Mental Disorders had already abandoned this form of categorization in with the publication of DSM-V in 2013. DSM-V diagnoses “collapse” different groupings of Autism into a single condition, ASD, while previous versions of DSM-III and DSM-IV categorized ASD patients into different groups. The ICD-10 system also used these same categorizations.
This is where severe autism under the old ICD-10 designation can come in. While children diagnosed under the current systems wouldn’t necessarily have these categorizations today, children diagnosed with F84 Autism had a subset of different, specific conditions that ran from F84.1 through to F84.9.
The most severe form of autism under the old ICD-10 standard was F84.4, named Overactive disorder associated with mental retardation and stereotyped movements. This was characterized by the following symptoms:
Severe mental retardation: Children diagnosed F84.4 was when evaluated for IQ, usually scored at 35, or less, where the average intelligence quotient is considered 100.
Hyperactivity: Children in this category show excessive levels of activity that is often paired with an inability to pay attention.
Stereotyped behaviors: In this case, stereotype refers to a repeated set of motions or behaviors that is triggered to a high degree. Rocking back and forth, complex hand movements, gazing, and other actions are repeated to excessive degrees, either unconsciously, or as a coping mechanism.
Severe autism can be extremely challenging for parents. This requires an extra level of care for a child, and likely means a very different, more attentive parental experience than what average families face. Patience and understanding are essential to the process.
