Last week, I asked whether readers felt the diagnoses Asperger syndrome and PDD-NOS (pervasive developmental disorder not otherwise specified) should be removed from the diagnostic manual. If they were removed, people with those diagnoses would presumably be reclassified as simply "on the autism spectrum."

A signficant majority of you (65%) felt that those diagnoses were useful and meaningful enough to continue to be listed in the DSM-V (the new version of the manual used by mental health diagnosticians).

Now for the big question: Is Asperger syndrome appropriately included under the autism spectrum umbrella? Or should it, perhaps, be a separate diagnosis of its own, unconnected to autism?

People with autism often have special gifts and talents.

Some are autistic savants - uniquely gifted prodigies in areas like math, music and language. Others surprise their parents, therapists and teachers with abilities that no one ever asked about - perfect pitch, an impressive talent for drafting and rendering, an amazing eye for morphological detail in plants and animals, or a terrific ability to learn and speak foreign languages.

In recent days, I've read about autistic artist Stephen Wiltshire, and received a gorgeous, full-color coffee table book called Drawing Autism, which is stuffed with outstanding artistic expressions by autistic artists of all ages. And just this morning, I received an email from my cousin with a link to a series of videos about a blind, autistic musician with impressive talents.

Two days ago, for the first time, I heard my son singing in the shower. And - who knew? - he has a lovely soprano voice, and can imitate the voices of professional vocalists he's heard on TV and radio!

If you're an adult with autism, what are your gifts? If you're a parent, what are your child's?

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Could two major autism diagnoses vanish into the mist?

According to an article in the New York Times, it's quite possible.  Both Asperger syndrome and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) are edging closer to the chopping block.  The  fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) may eliminate the terms:

...[if some] experts have their way, Asperger's syndrome and another mild form of autism, pervasive developmental disorder not otherwise specified (P.D.D.-N.O.S. for short), will be folded into a single broad diagnosis, autism spectrum disorder -- a category that encompasses autism's entire range, or spectrum, from high-functioning to profoundly disabling.

"Nobody has been able to show consistent differences between what clinicians diagnose as Asperger's syndrome and what they diagnose as mild autistic disorder," said Catherine Lord, director of the Autism and Communication Disorders Centers at the University of Michigan, one of 13 members of a group evaluating autism and other neurodevelopmental disorders for the manual.

"Asperger's means a lot of different things to different people," Dr. Lord said. "It's confusing and not terribly useful."

Of course, this is a hugely controversial idea.  Personally, I feel there's far too little distinction among "autisms" as it is.  I'd like to see autisms split into disorders that do and don't, for example, include physical, sensory or psychological symptoms - not further homogenized into a collection of people with every level of function, every type of symptom and every type of ability.

Where do you stand on this complex issue?

The burning questions surrounding autism are huge: what causes the disorder?  what treats it?  what cures it?  While lay people want answers to these questions NOW, science is a slow and painstaking process.  And while parents and caregivers may feel they already know the answers, researchers are more skeptical.

These differences are appropriate.  After all, researchers are following the scientific method in a (hopefully) objective manner, while parents and caregivers are raising kids and supporting adults who need help - right now.

But while scientists are certainly right to take the slow, methodical, step-by-step approach to finding answers, they may need to look to parents and families to formulate the questions.

All too often, researchers conduct research that they feel should be convincing and authoritative, only to find that parents and lay individuals are far from impressed.  In particular, studies which intend to reassure parents regarding the safety of vaccines or the non-association between autism and various environmental factors, are often disregarded.

There's a reason for this.  And it's not simply that non-scientists "don't get it."  For example, when a researcher says "epidemiological studies show that any risks associated with vaccines are far less than the risk posed by the disease against which the vaccine operates," parents may believe him.

But that doesn't settle the question: "how can I tell whether a vaccine is likely to injure my individual child?"  Nor does it explain "what happened when my child was vaccinated and appeared to regress almost immediately?"  The answer, all too often given, is "it was a coincidence," or "perhaps your memory failed you."  While coincidence is certainly a strong possibility, it's tremendously frustrating to parents to have their observations summarily dismissed.

When a study states that no connection has been found between gastrointestinal issues and autism, parents may point to other studies which seem to suggest that there IS such a connection.  They may also point to dozens of autistic children whom they know of personally who seem to have GI issues.  Their question: "is there a subgroup of children with autism who also do have GI issues, and if so - why?  and what do we do about it?"

When findings suggest that "children with autism" have certain qualities, or that certain treatments are effective or ineffective, it's helpful in forming policy.  But since individual children with autism may have radically different symptoms, abilities and histories, those findings are not particularly helpful for individual families.  In fact, so far, there's no evidence that one treatment approach or another is a better choice based on a child's symptoms or challenges.

Clearly, researchers can't focus on the needs of individual children or families.  But as we move forward to better understand what autism is (or what autisms are), what causes the disorder in its various forms, and so forth, it's important for physicians and researchers to understand what families need to know.

In the long run, it's the decisions of individual families, schools, insurance companies and program providers that will make the difference for people with autism.  If science can't respond to their question and concerns, they will find their own answers - and act on them.