By Hannah Anderson, Assistant Editor
The American Psychiatric Association has proposed changes to the definition of autism, which critics say could exclude many people who are currently diagnosed with the disorder.
The new criteria proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.) would combine four previously separate diagnoses (autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder) under one single label – autism spectrum disorder.
The D.S.M. is the standard manual for diagnosing and treating mental disorders, and The New York Times reported that the 5th edition would be the first revision in 17 years.
In a news release announcing the proposed changes, the APA said the current definition implies the four diagnoses on the autism spectrum are distinctive, and it says the new single diagnosis of autism spectrum disorder would make physicians specify the severity of an individual patient’s symptoms and his or her ability to cope with the disorder, rather than just giving a vague yes or no diagnosis to one of four disorders.
“This change will help clinicians more accurately diagnose people with relevant symptoms and behaviors by recognizing the differences from person to person, rather than providing general labels that tend not to be consistently applied across different clinics and centers,” the APA news release said.
However, a recent analysis of the new criteria showed that many higher-functioning people currently diagnosed with one of the four disorders in the autism spectrum might not fit the new criteria for Autism Spectrum disorder, The New York Times reported.
The analysis by Dr. Fred R. Volkmar, director of the Child Study Center at the Yale School of Medicine, and two other Yale researchers, used data from a 1993 autism study that was the basis for the current criteria. They found that only 45 percent of the 372 highest functioning children and adults would fit the new criteria for Autism Spectrum disorder.
The changes could narrow the criteria so much that it would effectively eliminate the current surge in autism diagnoses, Volkmar told the Times. “We would nip it in the bud.”
That potential effect concerns some advocates.
“Our fear is that we are going to take a big step backward,” Lori Shery, president of the Asperger Syndrome Education Network, told the Times. “If clinicians say, ‘These kids don’t fit the criteria for an autism spectrum diagnosis,’ they are not going to get the supports and services they need, and they’re going to experience failure.”
The APA says a decision is still months away, but that its recommendations are supported by more than a decade of intensive study and analysis.