There is a growing consensus to redefine the assessment and diagnosis of Autism Spectrum Disorder (ASD), which will culminate in the publication of the DSM-V expected to be released in 2013. The three symptom domains of the DSM-IV (impairment in socialization, language and speech deficits, and restricted repetitive patterns of behaviors) will likely become two in the DSM-V (Social/communication deficits and fixated interests and repetitive behaviors). Advanced knowledge and methods of diagnosis suggest that deficits in communication and social behaviors are inseparable and represent a single set of symptoms. Delays in language are not unique or universal in Autism Spectrum Disorder (ASD), which may be considered as a factor that influences the clinical symptoms of ASD, instead of a defining diagnosis of Autism Spectrum Disorder. Merging both criteria of social and communication deficits is thought to improve the specificity of the diagnosis of Autism Spectrum Disorder.
The DSM-V is proposing to regroup the five diagnostic categories listed in the DSM-IV, which include autistic disorder (autism), Asperger’s disorder, childhood disintegrative disorder, pervasive developmental disorder not otherwise specified (NOS), and Rett’s Disorder, into one category, autism spectrum disorder (ASD). Therefore, Autism Spectrum Disorder will include all previous categories except Rett’s Disorder and Childhood Disintegrative Disorder, which are understood to have a distinct genetic component.
Presently, the standard clinical practice is to make the diagnosis of autism prior to 3 years of age, especially for those individuals at risk of autism (developmental delays, challenging behaviors, birth defects, epilepsy among others conditions). Clinicians can use different tools (e.g. ADI-R, ADOS, M-CHAT) to make the diagnosis, although it can be a challenge to determine what evaluation tool to use.
Since the criteria for diagnosis in the DSM-V are based on certain observed behaviors and some social symptoms appear later in life especially for Asperger’s Disorders individuals, the diagnosis will likely continue to represent a challenge for clinicians and parents (Matson, et al. 2012). For instance, sometimes parents may have early concerns about some symptoms that are not included within the autism diagnostic criteria and not likely to result in the diagnosis at that time. Yet, at a late time, their child may still receive the diagnosis due to other presenting symptoms that are specific to the diagnosis. For making accurate diagnoses, we believe that clinicians should pay attention to motor and emotional problems, and/or the level of a child's activity in infancy (Lord et al. 2011). According to Lorna Wing and colleagues (2011), it seems that the DSM-V committee should make the DSM-V-criteria unequivocal and practical for clinicians. Ultimately, the precise diagnosis of autism is hindered by our incomplete understanding of the neuropathological basis of autism and the lack of objective biological measurements for its detection.
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DSM: The Diagnostic and Statistical Manual is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders.
11 comments:
It's interesting that the APA decided to put most of these conditions into one lump sum category. I wondering why they're doing it this way however. But simultaneously, I question whether or not the original classifications were better or worse than the new ones.
I find it difficult to formulate a good opinion on this topic, mostly because I only have a general understanding of these conditions. A more intimate knowledge of all of these conditions would make it easier for me to agree or disagree with this new classification.
THE D.S.M PUBLISHED, THE A.P.S IS INTERESTING ABOUT A.S.D I AGREE IN THIS KNEW CATEGORY BECAUSE THE STUDENTS WILL UNDERSTAND AND STUDY THE A.S.D. I THINK IS EXCELLENT IDEA PUT THESE CONDITION INTO ONE CATEGORY AND OTHER CONDITIONS PUT INTO PREVIOUS CATEGORIES. THEREFORE,WE COULD UNDERSTAND BETTER THIS DISORDER.
NOVEMBER 21, 2011 3:40 P.M
I find really interesting what we can expect to see on the DSM-V on 2013; specially when we talk about Autism and how it could be diagnosed for Psychologists when the kid is in his early childhood. That might help a lot to make some research to improve their social interaction by stimulating the right part of the brain that can control this kind of task.
when reading this post i couldn't make a judgement to weather it is necessary for the APA to change the current D.S.M IV diagnosis towards A.S.D, because either way the parents of a child diagnosed with A.S.D are not prepared to accept the complications of raising a child with this condition.
i believe that the conditions the APA put up were a bit extreme but knowing that a child with authcism does bring complications to the parents of the child. i feel like i can't really criticize these forms of classifications of the dsm. iv because i dont feel empathy for this type of disorder.
great depth of detail. i agree i also think the combination will make a clearer understanding of the disorder. im all about advancind i say go for it.
I think that if there is a system that works and helps in the diagnosis of autism effectively then it should be implemented; but it seems to me that the new system of diagnosis is just more complicated. If a new system is to work, then it should make the job of the therapists easier and ease the process on the child and the parents. Perhaps one thing that should be implemented,in case it has not been already;sudgestions and ideas from the therapists themselves- those who deal with the diagnosis of children on a daily basis; that, might shed some very important insight on this subject.
I believe that huddling these various conditions into one cluster is foolish. Individuals with different conditions will be jumbled in melting pot creating a disaster. In contrast, to separate treatment for individual cases, as a result, humans with different psychological disorders will not be attended meticulously.
It's true that deficits in communication and social behaviors are inseparable.And that the DSM-V is proposing to regroup the five diagnostic in the DSM-V is a good thing that will help clinicians with the diagnosis.However the DSM-V will only resolve the diagnosis of ASD in part because of the complexity of the disease.
The APA diciding to put most of the catergories into a large catergory makes me curious. What what was wrong with intial catergories? And how will the newly classified catergory prove to be an improvement ?
The people who would have the best answer to those questions stated above are the ones that will be most effected by the change.
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