The American Psychiatric Association board of trustees met Saturday in Washington D.C. to approve changes to diagnostic criteria of several psychiatric disorders, including autism, to be published in the DSM-V next May.
These changes were first discussed in May of this year.
The DSM is used by mental health professionals as a means of diagnosing patients and by schools, service providers and insurance companies to determine what disorders and treatments to cover. The previous revision of the DSM was published in 1994.
The major change to the diagnosis of autism is the use of the umbrella term of "autism spectrum disorder," which will combine the currently separate diagnoses of autism, Asperger's syndrome, pervasive developmental disorder - not otherwise specified (PDD-NOS) and childhood disintegrative disorder. Therefore, the individual diagnoses of the aforementioned disorders will no longer exist.
The goal of this, according to the APA, is to more accurately and consistently diagnose children as having "autism spectrum disorder," a term which is widely used by experts in the field today.
Many parents and advocates are concerned that these changes to diagnostic criteria may result in their children losing their diagnosis, and therefore their services, such as behavioral therapy. While it is difficult to predict in real-world settings how these changes will affect diagnosis, the panel of trustees in charge of researching and approving these changes assert that the new criteria point to more inclusionary and transparent criteria, rather than exclusionary, for several reasons:
- The new criteria will integrate gestures and verbal communication
- The domain of social behavior has been altered from "failure to develop peer relationships and abnormal social play" in the DSM-IV to "difficulties adjusting behavior to suit different social contexts" in the DSM-V
- A patient's history will be taken into account, rather than depending on behaviors that are observed during assessment, therefore the age of onset will be more flexible, allowing for older children to be diagnosed
- Severity of symptoms will be looked at, instead of checking off symptoms from the list of criteria such as stereotypy or language delay, which will help eliminate misinterpretation and misdiagnosis of another disorder, such as ADHD
- Many school districts and insurance companies do not currently cover services for children with an Asperger's diagnosis, therefore a diagnosis of "autism spectrum disorder" would aid in gaining services
In addition, the panel and other experts emphasized that those currently diagnosed will not lose their diagnosis when the changes go into effect, unless there is a discernible, clinical reason to reevaluate a patient.
The panel also recommended that parents and service providers report cases in which their children or clients lost services based on the new diagnostic criteria, so this can be closely monitored.
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