An update on DSM-5 from Geri Dawson of Autism Speaks:
Rather than three categories of symptoms (social, communication and repetitive behaviors), only two types of symptoms will be required (social communication and repetitive behaviors). “Pervasive developmental disorder” will now be simply called “autism spectrum disorder.” In fact, all subtypes will be collapsed under the one broad category of autism spectrum disorders.
Why? Because even expert clinicians cannot reliably distinguish among the different subtypes when they make their diagnoses. What one clinician calls high functioning autism, another calls Asperger syndrome. This lack of consistency occurs because the diagnosis of Asperger syndrome, as defined in the DSM-IV, is based on recall of early language acquisition. Such recall can prove difficult, especially when a diagnosis is being made later in life.
Also worth noting: according to Dr. Sue Swedo, the concern that the DSM-V would lead to some higher-functioning individuals would be de-classified raised by Dr. Fred Volkmar and others may be unfounded, because those studies were based on diagnoses using the DSM-IV.
The DSM-V includes a number of symptoms that were not part of previous iterations.
There has been a lot of concern about how the new DSM-5 diagnosis criteria would impact the diagnosis of autism and autism spectrum disorders; many parents are concerned that the new standards will prevent some children from being classified – which could mean they’d miss out on much-needed services.
Autism Speaks chief science officer Geri Dawson is tracking that issue, and released some preliminary results today:
This week brought the first results of field trials conducted with nearly 300 children at four pediatric autism clinics to assess differences in diagnosis rates using DSM-IV versus DMS-5 criteria. The encouraging news is that the vast majority of children diagnosed with ASD using the old criteria retained their diagnosis under the proposed new criteria.
Approximately 5 to 10 percent received a different diagnosis. Some of these received the new diagnosis of “social communication disorder.” Others received a primary diagnosis of attention deficit and hyperactivity disorder (ADHD).
Notably, the proposed DSM-5 criteria also “captured” some children who did not meet the definition of autism using the old DSM-IV criteria. This could be because there are some symptoms included in the new criteria (e.g. sensory sensitivities) that were not included in the old criteria. As a result, the overall rate of ASD diagnosis did not change between the DSM-IV and DSM-5 definitions of ASD.
The Yale Seminar on Autism and Related Disorders is the United States’ first undergraduate course of its kind. The class consists of a weekly seminar on diagnosis and assessment, etiology and treatment of children, adolescents and adults with autism and related disorders of socialization.