Exploring the Proposed DSM-5 Criteria in a Clinical Sample

20 Jul

The potential effect of the change from DSM IV to DSM 5 has generated quite a lot of interest within the autism community. Yes, I realize that is an understatement. In her presentation to the IACC, Sue Swedo (chair of the neurodevelopmental disorders work group for the DSM 5) stated that comments to the DSM 5 committee are running 10x higher for autism than any other diagnosis.

This week another study on the potential changes caused by the change to DSM 5 was published: Exploring the Proposed DSM-5 Criteria in a Clinical Sample. This from York University in Toronto, Canada. This study points, as others have, to the DSM 5 not diagnosing children who would meet the autism criteria under DSM IV. 19% of children studied with autistic disorder under DSM IV would not be picked up by DSM 5, according to this study. A much larger fraction–83%–of those with DSM IV PDD-NOS diagnoses would not receive ASD diagnoses under DSM 5 (again, according to this study).

Here is the abstract:

The proposed DSM-5 criteria for Autism Spectrum Disorder (ASD) depart substantially from the previous DSM-IV criteria. In this file review study of 131 children aged 2-12, previously diagnosed with either Autistic Disorder or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), 63 % met the new DSM-5 ASD criteria, including 81 % previously diagnosed with Autistic Disorder and only 17 % of those with PDD-NOS. The proportion of children meeting DSM-5 differed by IQ grouping as well, with higher rates in lower IQ groups. Children who did meet criteria for ASD had significantly lower levels of cognitive and adaptive skills and greater autism severity but were similar in age. These findings raise concerns that the new DSM-5 criteria may miss a number of children who would currently receive a diagnosis.

–by Matt Carey

3 Responses to “Exploring the Proposed DSM-5 Criteria in a Clinical Sample”

  1. farmwifetwo July 20, 2012 at 16:18 #

    Not terribly shocking. My eldest (going into Gr 8) per the child psych this spring says he still qualifies for autism per the IV and will be “social communication disorder” per the V.

    IQ – contrary to some bloggers – has nothing to do with it since people who cannot communicate socially, that get caught up in repetitous thoughts/behaviour (stims) would find passing the IQ nearly impossible. My youngest (going into Gr 6) is in the 60’s per the test but academically math/english is about a Gr 2. Expressive language skills about 2/3yrs of age. Speech about the same. When he gives me that blank look I change my question/comment and add a “yes or no” to the end so he can answer me. Ability to read orally and spell – he writes whatever he wants on the computer, usually reads like a ‘stim’ (logo’s, addresses, wall tracks etc) – at grade level. He does do formal writing, but I like the “stim” on his own more. It has nothing with being able to talk and everything with social skills, repetitious behaviour (fixations) and it must impact daily functioning. I had the “social with verbal apraxia and anti-social = autistic with verbal apraxia” explained to me when my youngest was 2yrs old and in speech therapy. Most children are the first…. autistic ones are the latter.

    Autism will return to being a “disability” with it’s own definitions. It will no longer take in non-verbal yet social people, ID yet social people, Downs Syndrome people etc that have hijacked the dx to get services. I’m looking forward to the change, even if one will no longer qualify. We’ll finally get a true accounting of the number of people with autism.

  2. Roger Kulp July 22, 2012 at 06:42 #

    We have heard so much about people at the mild end of the spectrum not being able to get a diagnosis under the DSM-V,it’s very good to hear the other side of the story.But what I would really like to know more about is what farmwifetwo says here.I am not sure,but I think this is the first I have heard about people who are nonverbal,or intellectually disabled,but meet none of the social criteria,getting an autism diagnosis.

    Has anything been published about this specifically?


  1. DSM-5 will capture the dynamic nature of mental illness « Health and Medical News and Resources - July 20, 2012

    […] Exploring the Proposed DSM-5 Criteria in a Clinical Sample (leftbrainrightbrain.co.uk) […]

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