New Autism Definition Will Not Exclude Most Children With Autism
Parents should not worry that proposed changes to the medical criteria redefining a diagnosis of autism will leave their children excluded and deemed ineligible for psychiatric and medical care, says a team of researchers led by psychologists at Weill Cornell Medical College.
Their new study, published in the American Journal of Psychiatry, is the largest to date that has tried to unpack the differences between the diagnostic criteria for autism spectrum disorders in the DSM-IV and the proposed revision in DSM-5, which is expected to be published in May 2013.
"I know that parents worry, but I don't believe there is any substantial reason to fear that children who need to be diagnosed with autism spectrum disorders, and provided with vital services, will not be included in the new criteria in this updated manual," says the study's senior investigator, Catherine Lord, PhD, director of the Center for Autism and the Developing Brain at NewYork-Presbyterian Hospital's Westchester campus, along with its affiliated medical schools Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.
At issue is whether DSM-5 will capture the same individuals diagnosed with different forms of autism by the DSM-IV. The DSM-5 proposal redefines autism as a single category, autism spectrum disorder (ASD), whereas DSM-IV had multiple categories and included autistic disorder, Asperger's disorder, and pervasive developmental disorder, not otherwise specified (PDD-NOS).
Critics have particularly worried that among the excluded will be children now diagnosed with PPD-NOS and Asperger's disorder. That isn't the case, says Lord. The study, the largest to date and arguably, the most rigorous, finds that when relying on parent report, 91% of the 4,453 children in the sample currently diagnosed with a DSM-IV autism spectrum disorder would be diagnosed with ASD using DSM-V.
Many of the remaining 9% would likely be reincluded once a clinician can offer input, says Lord. The study researchers also concluded that DSM-5 has higher specificity than DSM-IV—in their study, DSM-5 criteria resulted in fewer misclassifications.
— Source: NewYork-Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College