What’s in a Name? Changing the Way We Identify Autism Severity

2014-07-26 08:24

Most people have heard about the changes with the DSM-5, but how many have looked into the name changes it implements for autism? This author has and while asking others the question from most was--Why did they have to abolish important disorders to a numbered category?

It first must be said that there were other changes made to the DSM-5 as it pertains to the umbrella of autistic spectrum disorders, for information on those changes you are urged to further look it up. This article only covers the condensing and renaming of the descriptive names.

Changes to the Names of Autism
This author cannot argue that with the old way there was instant visual recognition. The more severe the child’s deficits the more severe they placed on the autism spectrum. Much like any other parent-of an autistic child--I hate change of any kind! Obviously these changes are not an exclusion from that rule; however there are good reasons to change the way things are done sometimes.

According to the DSM-IV the descriptive names of autism where:

• Severe Autism (Low Functioning)
• Moderate Autism (Moderate Functioning)
• Asperger’s Syndrome
• Mild Autism (High Functioning)

The DSM-5 has them listed as follows:
• Autism Level 1
• Autism Level 2
• Autism Level 3


Essentially what they have done is taken severe autism and renamed it Autism Level 3. They then removed Asperger’s Syndrome from the spectrum subsequently combining it in with Moderate Autism making Autism Level 2. PDD-NOS (Pervasive Developmental Disorder Not Otherwise Specified) was also removed from the spectrum subsequently combining it with Mild Autism making Autism Level 1.

It has to be disclosed that it bothers this author greatly that the Asperger’s and PDDNOS diagnoses have been removed and combined into levels 1 and 2. This annoyance centers from the fact that these children are undeniably special in ways that should not be so simply defined by the world as being high or moderately functioning. It would have to be imagined that the disdain for these changes from parents that have children diagnosed with these disorders has to be heightened quite a bit from mine.

The Reasons for these Changes
There are two main causes for these changes that this author can see. One clearly stated by Dr. Bryan King, director of Seattle Children’s Autism Center, he also served on the board charged with overhauling the DSM-IV criteria, “There wasn’t any evidence after 17 years that the DSM-IV diagnoses reflected reality. There was no consistency in the way Asperger’s or PDD-NOS was applied”. Also made clear is that these changes do not require a new diagnosis, current diagnoses will be transferred automatically to the new ASD 1, 2, or 3.

One of the problems faced by the DSM-IV is the way one child was diagnosed and then classified fluctuated considerably dependent on where the child was seen. For instance, a big problem that parents were seeing is that in one state insurance may cover services for mild/high functioning autism, but refuse to acknowledge PDDNOS, same thing concerning Asperger’s Syndrome. It’s hard to get treatment if your disorder isn’t even recognized as being on the autism spectrum by your insurance. You also have to look at the assorted ways doctors diagnosed and treated autism. These changes as a whole give consistency. Doctors and Researchers are hoping to eliminate the confusion.


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Public schools are already jumping on it and trying to put square pegs in round holes. To me they have erased years of hard work to get my son properly placed. So we are back to square one and fighting as his class was eradicated after one year and we will be going thru another transitional year with all the "bugs" to work out as well as major new ones.
This article has numerous errors. The most obvious of which is that DSM-IV did not have the five categories listed. Another obvious error is that ASperger's is not being re-labeled as moderate severity ASD. Another error or oversight is to describe the significant clinical problems created by using diagnostic sub-categories that shift and have limited to know validity. Furthermore the empirical evidence suggested two diagnostic domains - social communication and repetitive Behaviors - not three as were in DSM-IV. Also, The desire to merge with ICD is also greatly overstated in this article. DSM-5 was a major step forward using available empirical data to develop a more rationale approach. Articles like this mislead the public and cause a "general feeling" that the mental health field is not making progress when it is. Although I suspect the article will get many clicks because it preys on anxiety and upsets. Even looking at the first comment this is obvious. It is much easier for people to blame the system than to take work onto their shoulders to get their child's needs met. That is human nature and will always be so but articles like this don't need to prey on it.
This article is well researched and any parent will tell you it is. Emaxhealth.com requires hyperlinks in their articles providing proof of facts. The dsm is hyperlinked on here along with all the other information in this article. Emaxhealth as well as myself checked facts before this article was approved.