The 2013 Updated DSM-V Changes on Autism Made Simple
Reading up on the new DSM-V might confuse many parents of autistic children. As such, this article is meant to simplify some of the important changes that were made in the latest DSM-V update in May 2013, pertaining to the diagnosis of autism in children and adults.
The full DSM-V Autism diagnostic criteria can be found on the Autism Speaks website catering to the community at large with factual and relevant information concerning the disorder.
What are the changes?
- Autism is no longer classified under subtypes: Pervasive Developmental Disorder, Asperger Syndrome, Child Disintegrative Disorder and Autistic Disorder
- All autistic symptoms are now classified simply under "Autism Spectrum Disorder"
- Individuals with ASD must show symptoms from early childhood, even if those symptoms are not recognized until later on
- Social communication impairment and restricted interests/repetitive behaviors are now the only two categories used for diagnosis, combining the former social impairment and language/communication categories
- Social Communication Disorder (SCD) has been added to include children whose problems are exclusively social communication related, no longer to be included under the autism category
- Rhett Syndrome is not classified under autism, but sufferers also often have autistic symptoms
- Symptoms need to be functionally impairing and not better described by another DSM-5 diagnosis
Note: Re-diagnosis is unnecessary for children with Asperger's but those diagnosed with PDD-NOS should go in for re-evaluation.
A study of late in the Journal of Child Psychology and Psychiatry points out a few concerns.
- Proposed DSM-5 criteria may not identify the more able individuals currently diagnosed with high-functioning autism and Asperger syndrome
- Reported sensitivity and specificity of the new criteria is inconsistent across studies
There is, however, good sensitivity reported across age and ability levels, which might protect against many concerns that may arise within the field.
In order to be diagnosed, children must display functional impairment, including:
- Problems reciprocating social or emotional interaction, including difficulty establishing or maintaining back-and-forth conversations and interactions, inability to initiate an interaction, and problems with shared attention or sharing of emotions and interests with others.
- Severe problems maintaining relationships — ranges from lack of interest in other people to difficulties in pretend play and engaging in age-appropriate social activities, and problems adjusting to different social expectations.
- Nonverbal communication problems such as abnormal eye contact, posture, facial expressions, tone of voice and gestures, as well as an inability to understand these.
Furthermore, 2 of these four symptoms must be present:
- Stereotyped or repetitive speech, motor movements or use of objects.
- Excessive adherence to routines, ritualized patters of verbal or nonverbal behavior, or excessive resistance to change.
- Highly restricted interests that are abnormal in intensity or focus.
- Hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment.