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Monday, May 7, 2012

Public Comments Reopened for DSM 5 Autism Diagnostic Criteria - Please Participate!

The APA (American Psychiatric Association) has reopened public comments on the proposed changes to the diagnostic criteria for autism in the DSM 5.The page for ASD diagnostic criteria can be found under the neurodevelopmental disorders category.

For those not familiar with the proposed changes to the diagnostic criteria for autism spectrum disorders, this is a quick overview:

The Pervasive Developmental Disorder category will be changed to Autism Spectrum Disorder (ASD). The current diagnostic labels of Asperger's Disorder and PDD-NOS will be folded into ASD - those labels will no longer exist.

In the current diagnostic manual, DSM-IV, there are 3 domains that are part of an autism diagnosis - Social, Communication, and Restricted/Repetitive behaviors. In DSM 5, the Social and Communication criteria are collapsed into one category. The Restricted/Repetitive behaviors category will now include sensory differences as one of the criteria.

A new severity scale is being added to classify the level of support the individual with ASD requires.

So why should you care how autism is diagnosed? There is tremendous concern that the changes will effectively un-diagnose a large percentage of the individuals currently diagnosed with Asperger's or PDD-NOS and that going forward individuals who would currently meet the criteria for those PDDs would go without a diagnosis. Lack of diagnosis does not change the challenges that those individuals experience, but it will limit their access to interventions, services, special education, and health insurance coverage (including in North Carolina, if the autism insurance mandate bill becomes law). Diagnosing fewer people with autism will not change the facts of the autism "epidemic"; it will only make it harder for children (and adults) to receive the support they deserve.

Several studies have shown that one small change to the proposed criteria for DSM 5 can make the tool more effective in finding those who might otherwise be pushed out into limbo when the manual goes into effect. Rather than requiring that a person meet 3 out of 3 symptoms for criteria A (Social/Communication), the APA should change it to meeting 2 out of 3 items for criteria A. It is believed that making that one small revision will ensure that the majority of people currently diagnosed with Asperger's and PDD-NOS will remain on the autism spectrum, as they should be.

The public comment period runs through June 15th, 2012, and I urge everyone to visit the DSM 5 website to comment and make your voices heard.

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