Category: Law

CA Regional Center fails sniff test.

Yes, San Andreas Regional Center   seems in the dark regarding  autism. There are 20+ regional center services    that provide services to substantially disabled persons  in California diagnosed with autism and other developmental disorders.

But maybe  SARC  is  just  whistling in the dark – hoping that the criteria   and the number of children getting diagnosed with  autism will change soon.

  For sure, San Andreas Regional Center  keeps  some families in the dark about autism.

For example, look what San Andreas Regional Center  incorrectly  wrote to one family when the agency  denied services.  The statement below paraphrases  what  the family received and is not an exact quote.  The letter states:

Autistic Spectrum Disorder is diagnosed when the impairments in communication  and    social interactions  are pervasive and sustained and  not supported by …. 

The letter referred to  was  signed by the San Andreas Regional Center  specialist for autism.  This person  knows and  sets policies. 

Note the use of the word “communication” in the denial for services letter.   What!!  That is so misleading!

When making a diagnosis of autistic spectrum disorder the clinician must state whether the child with autism has or does not have communication difficulties.   Yes –  using the DSM5 criteria for autism — children can be diagnosed with autism and not have communication difficulties.

First of  all, this  denial letter is not accurate concerning the child’s possible  “communication” deficits.   The issue is social communication difficulties not whether this child can verbally communicate.

Secondly, this  SARC  denial letter leaves out  any discussion whether the child has restricted, repetitive  patterns of behavior or activities.

 To summarize,  SARC leaves out one main area [restricted, repetitive patterns of behavior or activities]  and the other area [social communication and social interactions]  is discussed incorrectly.  This above quote is from the letter  one family got from  SARC as an explanation why their child has been denied  California regional center services.

What SARC aka San Andreas Regional Center  should have written:

Autism is diagnosed when there are  “Persistent deficits in social communication and social interaction across multiple contexts…” and those social deficits are  coupled with  “restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following, currently or by history….

The diagnosis of autism changed dramatically when the Diagnostic and Statistical Manual Fourth Edition (DSM-4) was replaced by DSM5.

You decide.  Is SARC in the dark, whistling in the dark or  keeping  some families in the dark  about autism?

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http://www.sanandreasregional.org/

http://psychcentral.com/blog/archives/2012/12/02/final-dsm-5-approved-by-american-psychiatric-association/

Diagnostihttp://www.icd9data.com/2012/Volume1/290-319/295-299/299/299.0.htmc Criteria for Autism Spectrum Disorder

DIAGNOSTIC CRITERIA FOR AUTISTIC SPECTRUM DISORDER

1. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive):
   1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
   2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and non-verbal communication.
   3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
2. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive):
   1. Stereotyped, or repetitive motor movements, use of objects, or speech (e.g. simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
   2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g. extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
   3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g. strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
   4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
3. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capabilities, or may be masked by learned strategies in later life).
4. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
5. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.