The American Psychiatric Association has published the proposed draft revisions for the DSM-V, which is scheduled to be published in 2013. Included in the proposed changes is a new set of diagnostic criteria for Autistic Disorder – 299.00
The term “Autism Spectrum Disorder”, which is commonly used by parents and autism professionals, will also be used as a synonym for Autistic Disorder.
The following is the proposed revision diagnostic criteria for Autistic Disorder in the DSM-V:
Must meet criteria 1, 2, and 3:
1. Clinically significant, persistent deficits in social communication and interactions, as manifest by all of the following:
a. Marked deficits in nonverbal and verbal communication used for social interaction:
b. Lack of social reciprocity;
c. Failure to develop and maintain peer relationships appropriate to developmental level
2. Restricted, repetitive patterns of behavior, interests, and activities, as manifested by at least TWO of the following:
a. Stereotyped motor or verbal behaviors, or unusual sensory behaviors
b. Excessive adherence to routines and ritualized patterns of behavior
c. Restricted, fixated interests
3. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)
The social and communication deficits used to diagnose autism spectrum disorders with the DSM-IV have been merged into a social/communication deficit domain. It is important to note that a statistically significant delay in language will no longer be needed in order for an individual to be diagnosed with autistic disorder using the DSM-V.
To help differentiate between what was once Asperger’s Syndrome, PDD-NOS, and autistic disorder, the American Psychiatric Association (APA) will propose severity criteria. These criteria are currently unavailable.
The APA has listed two rationale for the proposed changes:
- Differentiation of autism spectrum disorder from typical development and other “nonspectrum” disorders is done reliably and with validity; while distinctions among disorders have been found to be inconsistent over time, variable across sites and often associated with severity, language level or intelligence rather than features of the disorder.
- Because autism is defined by a common set of behaviors, it is best represented as a single diagnostic category that is adapted to the individual’s clinical presentation by inclusion of clinical specifiers (e.g., severity, verbal abilities and others) and associated features (e.g., known genetic disorders, epilepsy, intellectual disability and others.) A single spectrum disorder is a better reflection of the state of knowledge about pathology and clinical presentation; previously, the criteria were equivalent to trying to “cleave meatloaf at the joints”.
I’m curious what your thoughts are about the changes. Will these new changes affect the services that your child receives through the state or health insurance?