Comparing Symptoms of Autism Spectrum Disorders in a Developmentally Disabled Adult Population Using the Current DSM-IV-TR Diagnostic Criteria and the Proposed DSM-5 Diagnostic Criteria

8 Aug

The proposed change in diagnostic criteria for autism (from DSM IV to DSM 5) has been a topic of much discussion. To put it mildly. Little, if any, data has been available on how this change may affect the adult population.

A recent study seeks to address that void:

Comparing Symptoms of Autism Spectrum Disorders in a Developmentally Disabled Adult Population Using the Current DSM-IV-TR Diagnostic Criteria and the Proposed DSM-5 Diagnostic Criteria

Reseaerchers studied autistic adults with intellectual disability. They found that 36%  of their study population would lose their diagnosis under DSM 5.

The American Psychiatric Association is making changes in the autism spectrum disorder (ASD) criteria for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). In order to examine potential effects of the changing of the criteria, 330 adults with intellectual disability (ID) from two developmental centers were examined. However, due to the fact that the DSM-IV-TR/ICD-10 Checklist does not contain one of the restricted behavior items listed in the current proposed DSM-5 criteria, 41 participants were eliminated from the study. An additional 62 individuals were randomly removed from the study so that no one group was 1.5 times larger than any other group. This left a total of 227 individuals. These individuals were divided into three groups: those who met criteria for an ASD according to only DSM-IV-TR criteria, those who met criteria according to the proposed DSM-5 criteria, and controls with ID not meeting ASD criteria according to either diagnostic system. After statistical analysis, individuals in the DSM-5 group evinced significantly greater overall ASD core symptoms than those in the DSM-IV-TR group or controls. In addition, those in the DSM-IV-TR group exhibited significantly greater overall ASD core symptoms than those in the control group. Furthermore, we found that the percentage of adults diagnosed with ASD declined by 36.53% when using DSM-5 as compared to DSM-IV-TR criteria. Implications of these findings are discussed.


by Matt Carey

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9 Responses to “Comparing Symptoms of Autism Spectrum Disorders in a Developmentally Disabled Adult Population Using the Current DSM-IV-TR Diagnostic Criteria and the Proposed DSM-5 Diagnostic Criteria”

  1. farmwifetwo August 8, 2012 at 12:20 #

    And……..

    I’m not surprised. ASD is the catch all phrase to get services. There isn’t any outside of that dx b/c nobody has lobbied hard enough to get them. I’ve been to SO and there was one man that under the IV would have probably been dx’d as autistic solely b/c he was non-verbal. Thing is, he was social. He deliberately attempted to get Russ’ attention more than once and once by pouring an entire bottle of water onto the bowlers below and laughing and watching Russ. Russ ignored him the entire time he was there.

    Autism is SOCIAL or a lack thereof. It is not ID, it is not a lack of speech, it is not an upset stomach. Mine barely talks – about a 2yr old level, enough to say what he needs to and not interested in building sentences – but mine is TOTALLY mindblind to anyone else except for those within his personal sphere and even then he has to be reminded to communicate not just wander off. Even if it’s a simply yes or no. This is noted in the V’s description under social – except for caregivers.

    They’ve added in the repetitious behaviours – got those although mine aren’t as severe as some – and sensory – that would include covering one’s ears while the directional signal is on, don’t you think???

    I’m expecting the numbers to drop drastically. Not just the bottom but also the top. My eldest was told only a couple of months ago that under the IV he is still HFA, but under the V he’s social communication disorder…. All those “have a real job, family, married, etc” Aspies… they’ll be gone too.

    • K Hedges August 9, 2012 at 11:56 #

      Wow, someone has a great case of black and white thinking. I am really cranky today, and your gloating about how many autistics are going to lose their eligibility for help definitely rubbed me the wrong way.

      Presumably you think that only people with 100% loss of vision should be considered legally blind, not those posers who can still detect light or read letters a handspan high on a computer screen at arm’s length, let alone those phonies claiming that a 10degree field of vision isn’t enough to drive. Let’s just make all these people compete with everyone else without accommodations or supports, because they’re not REALLY blind.

      Autism is a spectrum disorder, and there are gradations in social impairment. It’s also a delay in development, and some improvement can occur over time. Some symptoms can also be masked with enough training in some people–that’s what ABA is all about. If someone is trained to stop doing repetitive behaviors, but they still have those urges, should this count towards a diagnosis of autism? If someone is trained to say please and thank you and stare at other people’s eyes, but they wish they didn’t have to do these things, should this count against them?

    • Autumn Henderson July 2, 2013 at 06:31 #

      Sorry to disappoint you… but not really. My son was recently diagnosed with aspergers, now under the umbrella of ASD per the DSM-V. I asked if he would need to have a new evaluation after its release. There answer was an emphatic “no”. He still clearly meets the criteria for an ASD. Due to his diagnosis and my research I became aware that my own behaviors and severe symptoms were similar to my sons as I have had huge impairments my whole life with socualuzing and sensory symptoms. I am divorced and have very few friends save those that I push myself to be with to provide much needed socialization for both of my children. I just struggled to finally finish my BBA at age 35 and am terrified of employment having been out of the workforce for over a decade. I have held a 40 hour work week that required large ammounts of time spent working with others. I am also a female that would have been completely missed because of that combined with my age and because I did not suffer from being non-verbal and I have a high IQ. Guess what? I have a mother who understands that I have struggled with all of these things and unfortunately still has to provide a great deal of financial and emotional support for me… even when I meltdown. Yes, I am a grown up who melts down, and saddly it is mostly with her because I have to try to function optimally everywhere else. And this mother of mine was willing to provide information via numerous interviews about my development and behaviors as a child and growing up. This combined with my own interviews and several tests inclyding an MMPI were compiled and it was clear that I qualify for an ASD under the new DSM-V criteria. There is no quackery here. They don’t just hand this diagnosis out like candy. ALL of my doctors have reviewed and concur. It is such a relief to finally have something that fits because with this understanding I can work to learn better ways to live my life knowing that sometimes I DO see thongs differently from everyone else and I am not just WEIRD as I have been told countless times all of my life by bullies or simply thoughtless/careless people. You are no different than them farmwifetwo… with your reverse discrimination. So, i’m sorry to disappont you… but not really.

      • Lara Lohne July 3, 2013 at 19:45 #

        Autumn, Your situation is much like my son and my partner. I may or may not fall on the spectrum myself. I have tendencies, but every evaluation I’ve taken half have put me on, the other half put me barely off, so I don’t know. Anyway, I don’t have much of a social life outside of social media but I am always looking for adults spectrumites. If you are willing, look me up and friend me on Facebook!

  2. Michael John Carley August 8, 2012 at 15:01 #

    Link to study doesn’t work. Can you re-do?

    Thanks for all, LBRB!

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