{"id":2881,"date":"2012-12-19T10:17:06","date_gmt":"2012-12-19T15:17:06","guid":{"rendered":"http:\/\/geraldguild.com\/blog\/?p=2881"},"modified":"2013-04-10T11:22:32","modified_gmt":"2013-04-10T15:22:32","slug":"autism-and-the-dsm-5","status":"publish","type":"post","link":"https:\/\/geraldguild.com\/blog\/2012\/12\/19\/autism-and-the-dsm-5\/","title":{"rendered":"Autism and the DSM-5"},"content":{"rendered":"

There has been a lot of talk in the media about the forthcoming DSM-5 and the diagnosis of Autism.\u00a0 The DSM-5 is the Fifth Edition of the D<\/strong>iagnostic and S<\/strong>tatistical M<\/strong>anual<\/a> used by Doctors to make diagnoses pertaining to Autism and other behavioral and mental health disorders.\u00a0 There are in fact two major changes in this newest edition regarding Autism.\u00a0 The first has to do with changes to the name of the diagnosis.\u00a0 The second has to do with the actual diagnostic criteria used to make a diagnosis.<\/p>\n

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Currently, when presented with a child who exhibits some characteristics of Autism, Doctors have to determine whether or not the child exhibits a sufficient array of clinically significant symptoms to warrant a diagnosis.\u00a0 This process requires the clinician to rule out other disorders that may instead be causing the problematic symptoms.\u00a0 The clinician also has to make a differential diagnosis to determine which of the Pervasive Developmental Disorders best describes the child.\u00a0 Many professionals, me included, believe that the dividing lines between the various forms of Autism are difficult to distinguish.\u00a0 The new DSM does away with this problem by eliminating the different labels (Autistic Disorder, Asperger\u2019s Disorder, PDD-NOS, Childhood Disintegrative Disorder) and instead puts in place a more general term \u2013 Autism Spectrum Disorder (ASD).\u00a0 Many researchers and clinicians agree that this change is warranted.<\/p>\n

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When the DSM-5 is published in May of 2013, children who previously would have been diagnosed with Autistic Disorder, Asperger\u2019s Disorder, or PDD-NOS, will be given the new diagnosis – Autistic Spectrum Disorder (ASD).\u00a0 A differentiation will then be made by indicating the degree of symptom severity.\u00a0 Specifically, those with more classical Autism will be diagnosed with ASD-Severe.\u00a0 At the other end of the spectrum, children diagnosed with Pervasive Developmental Disorder \u2013 Not Otherwise Specified (PDD-NOS) will likely get an ASD-Mild designation.\u00a0 Those with Asperger\u2019s may fall anywhere from ASD-Severe to ASD-Mild, depending on the degree of impairment.\u00a0 Many with Asperger\u2019s will likely fall in the Moderate range.\u00a0 To be clear however, Classical Autism may span Severe to Mild ASD while PDD-NOS will likely span Moderate to Mild ASD.\u00a0 Again, the severity designation depends on the number and severity of symptoms present.\u00a0 If your child already carries a diagnosis, little will change, except perhaps how professionals refer to the disorder itself.\u00a0 \u00a0Your child will be referred to as being on the Autistic Spectrum.<\/p>\n

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The second change involves a modification of the Diagnostic Criterion used to provide a diagnosis.\u00a0 When making a diagnosis, a clinician such as myself, has to have evidence of a sufficient array of behaviors listed in the DSM in order to provide a diagnosis.\u00a0 The behaviors commonly associated with Autism make up the list of Diagnostic Criterion in the manual.\u00a0 The new DSM includes an update of the behaviors used as these criteria.\u00a0 It defines ASD by two sets of core features, namely: 1) impaired social communication and social interactions; and 2) restricted and repetitive behavior and interests. It more appropriately reorganizes the symptoms in these domains and adds sensory interests and sensory aversions to the list.<\/p>\n

 <\/p>\n

The new version is touted as an improvement because it adds to and reorganizes the diagnostic criterion so that they better address the needs of people with ASD across all developmental levels and ages.\u00a0 It also includes improvements to better address the atypical symptom presentation of girls.\u00a0 The goal of DSM-5 is to apply what is detailed in the scientific literature so as to add precision and validity to the diagnostic process.<\/p>\n

 <\/p>\n

As with any change, there have been some concerns expressed in the media.\u00a0 Perhaps the most frequently heard concern is the fear that those at the mildest end of the spectrum with strong cognitive capabilities will no longer qualify for the diagnosis and thus may lose services.\u00a0 Advocacy groups such as Autism Speaks<\/a> have been actively engaging in this reorganization process and the American Psychiatric Association<\/a> (the publisher of the DSM) has made statements<\/a> aimed to calm the concerns.\u00a0 They suggest that clinical judgment remains a crucial piece of the diagnostic process and that the new criteria are designed to be completely inclusive of those diagnosed using the current DSM-IV.\u00a0 The research released by the\u00a0American Psychiatric Association shows improved reliability and validity of diagnoses using the DSM-5 and strong inclusiveness of those already diagnosed using the DSM-IV.\u00a0 I have seen the proposed diagnostic criterion and upon review I did not have any serious concerns with regard to how it will affect my ability to make diagnoses.<\/p>\n

 <\/p>\n

The bottom line is that for most parents, there will be no appreciable change other than how we refer to your child.\u00a0 In anticipation of this change we have already been using the phrase Autism Spectrum Disorder or \u201con the spectrum\u201d for quite some time now.\u00a0 Diagnoses in the near term will still be made using the current DSM-IV, and thus, we will still be using the terms Autistic Disorder, Asperger\u2019s Disorder, and PDD-NOS.\u00a0\u00a0 It is advisable for clinicians\/diagnosticians to commence using both sets of terminology so as to minimize confusion in the future.\u00a0 Sharing a document such as this one with the parents of the newly diagnosed is also advised.<\/p>\n","protected":false},"excerpt":{"rendered":"

There has been a lot of talk in the media about the forthcoming DSM-5 and the diagnosis of Autism.\u00a0 The DSM-5 is the Fifth Edition of the Diagnostic and Statistical Manual used by Doctors to make diagnoses pertaining to Autism and other behavioral and mental health disorders.\u00a0 There are in fact two major changes in … <\/p>\n

Read more “Autism and the DSM-5”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[100,37],"tags":[47,101],"class_list":["post-2881","post","type-post","status-publish","format-standard","hentry","category-autism","category-psychology","tag-autism","tag-parenting"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/p3mcUm-Kt","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/geraldguild.com\/blog\/wp-json\/wp\/v2\/posts\/2881","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/geraldguild.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/geraldguild.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/geraldguild.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/geraldguild.com\/blog\/wp-json\/wp\/v2\/comments?post=2881"}],"version-history":[{"count":23,"href":"https:\/\/geraldguild.com\/blog\/wp-json\/wp\/v2\/posts\/2881\/revisions"}],"predecessor-version":[{"id":2901,"href":"https:\/\/geraldguild.com\/blog\/wp-json\/wp\/v2\/posts\/2881\/revisions\/2901"}],"wp:attachment":[{"href":"https:\/\/geraldguild.com\/blog\/wp-json\/wp\/v2\/media?parent=2881"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/geraldguild.com\/blog\/wp-json\/wp\/v2\/categories?post=2881"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/geraldguild.com\/blog\/wp-json\/wp\/v2\/tags?post=2881"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}