The American Psychiatric Association ("APA") is finalizing the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (the "DSM"), the first major revision in 17 years. Proposed revisions in the DSM-5 may narrow drastically the definition of autism spectrum disorder.
The proposed name change would consolidate diagnoses under one category, Autism Spectrum Disorder, eliminating Asperger’s Disorder, Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), Autistic Disorder (autism) and Childhood Disintegrative Disorder from the manual.
Under the current criteria (DSM-IV-R), a person can qualify for a diagnosis of Autistic Disorder by exhibiting a total of six (or more) items (out of 12 behaviors) in three categories:
1. Qualitative impairment in social interaction
2. Qualitative impairments in communication
3. Restricted repetitive and stereotyped patterns of behavior, interests, and activities
Under the proposed definition, three domains become two:
1. Social/Communication deficits
2. Fixated interests and Repetitive behaviors
To qualify, a person would have to exhibit persistent deficits in social communication and social interaction in 3 sub-domains and at least 2 (out of 4) fixated interests and repetitive behaviors.
There is much recent debate that this narrowing of domains will have an effect on the incidence of autism diagnoses and potentially services.
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